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MILTON  M.    LEDNAPD,    D.V.M. 


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THE 


COMMON    COLICS    OF    THE    HORSE 


THE    COMMON   COLICS 
OF  THE   HORSE 


XTbetr  dauses,  Symptoms,  Dtaonosts,  anb 
treatment 


BY 

H.  CAULTON   REEKS,  F.R.C.V.S. 

EXAMINER    IN    PATHOLOGY   AND    BACTERIOLOGY    TO   THE     BOAKD    OF    EXAMINEKS 
OF     THE    ROYAL    COLLEGE    OF    VETERINARY   SURGEONS 

AUTHOR   OF    '  DISEASES   OF   THE    HORSE's    FOOT 


SECOND   EDITION 


CHICAGO 
ALEX.     EGER 

1909 


SIR  JOHN    M'FADYEAN 

(M.B.,  B.Sc,  F.R.S.E.), 
Principal  and  Dean  of  the  Royal  Veterinary  College,  London. 

AS    A    MARK    OF    RESPECT 


PREFACE  TO  THE  SECOND  EDITION 

Six  years  have  elapsed  since  this  little  work  was  first 
published,  and  the  passage  of  time  has  renderad  necessary 
a  few  alterations  and  additions.  The  task  of  penning 
these  has  been  a  pleasant  one,  for  the  fact  that  after  the 
exhaustion  of  the  first  edition,  and  a  second  large  reprint 
of  it,  a  second  edition  should  be  called  for  is  gratifying 
proof  that  the  book  has  supplied  a  need  and  served  some 
useful  purpose.  It  now  only  remains  for  me  to  mention 
anything  of  importance  concerning  the  reception  of  the 
first  edition  that  would  interest  the  reader  of  the  second, 
and  to  record  here  the  alterations  that  have  been  made. 

In  the  reception  accorded  the  first,  the  most  pleasing 
feature  to  me  was  the  number  of  unsolicited  letters  it 
brought  me  from  practitioners,  both  English  and 
American,  concerning  what  I  have  now  come  to  call  the 
'  stimulant '  treatment  of  intestinal  impaction.  Many 
who  have,  in  the  phrase  of  one  of  them,  ^ put  their  sedatives 
on  the  shelf^^  have  written  in  terms  expressive  of  their 
delight  with  the  change,  and  assuring  me  that,  if  I 
needed  confirmation  of  the  correctness  of  the  treatment, 
their  own  experience  would  give  it.  Although  pleasing 
to  me,  I  merely  mention  this  fact  here  in  order  that  the 
reader,  should  he  contemplate  a  change  which  at  first 
sight  may  appear  to  him  startling,  may  be  assured  that, 
concerning  its  wisdom,  he  has  not  to  rely  on  my  word 


viii  PREFACE  TO  THE  SECOND  EDITION 

alone.  He  now  has  corroborative  testimony.  In  this 
connection,  seeing  that  it  is  more  or  less  a  summary 
of  the  arguments  both  for  and  against  the  stimulant 
treatment,  I  may  point  out  that  I  have  now  included  in 
the  Appendix  (Part  II.)  an  article  on  '  The  Use  and 
Abuse  of  Sedatives  in  the  Treatment  of  the  Equine 
Colics.' 

Regarding  the  other  additions,  perhaps  the  most 
important  is  that  of  Chapter  X.,  on  '  Subacute  Obstruc- 
tion of  the  Pelvic  Flexure  of  the  Colon.'  This,  I  hope, 
is  a  further  step  towards  the  clearer  diagnosis  of  intes- 
tinal obstructions,  and  I  trust  the  matter  there  recorded, 
together  with  the  diagrams  illustrating  it,  will  lead  others 
to  a  comprehension  of  these  troubles  even  more  exact 
still. 

To  Chapter  II.,  which  deals  with  the  surgical  anatomy, 
I  have  added  diagrams  which  may,  perhaps,  define  more 
clearly  than  the  words  the  formation  of  the  so-called 
cardiac  sphincter  of  the  stomach. 

Appended  to  Chapter  VII.,  that  on  '  Gastric  Tympany,' 
there  is  a  description  and  illustration  of  a  new  stomach- 
tube,  which  shows  piomise  of  being  of  use  in  the  treatment 
of  both  gastric  tympany  and  gastric  engorgement. 

Of  alterations,  there  is  only  one  of  importance.  It 
deals  with  a  change  of  opinion,  which  I  should  be  dis- 
honest in  withholding,  and  will  be  found  fully  set  out  in 
Part  III.  of  the  Appendix. 

In  conclusion,  I  again  commend  this  book  to  the 
veterinary  practitioner,  asking  him,  above  all,  to  make  it 
but  an  aid  towards  the  achievement  of  an  end  w^e  must 
all  of  us  have  in  view — the  further  elucidation  of  the 
troublesome  affections  with  which  it  deals. 

H.  C.   R. 

Spalding, 

January,  1909. 


PREFACE  TO  THE  FIRST  EDITION 

At  the  commencement  of  a  volume,  be  it  small  or  large, 
it  is  usual  to  make  a  few  prefatory  remarks.  The  cus- 
tom is  a  wise  one,  for  it  enables  the  author  to  state  the 
various  conditions  and  circumstances  that  brought  the 
book  into  being,  to  put  forth  clearly  the  object  and 
general  scope  of  the  work,  and  to  apologize,  where  need 
be,  for  the  imperfections  it  contains.  Lastly,  it  affords 
an  opportunity  to  inform  the  reader  of  the  sources  whence 
the  material  for  the  work  was  obtained. 

The  conditions  and  circumstances  that  brought  this 
little  volume  into  existence  are  few  but  important. 
The  practice  into  which  I  settled  soon  after  qualifying 
was  one  in  which  cases  of  so-called  '  colic '  bulked  very 
largely.  Their  extreme  importance  to  the  stock-owner, 
the  large  measure  of  anxiety  and  responsibility  they  give 
the  veterinarian,  and  the  short  time  the  horse  will  suffer 
before  succumbing,  are  all  circumstances  that  render 
their  accurate  diagnosis  and  treatment  a  matter  of  the 
utmost  urgency. 

The  gravity  of  the  cases,  and  the  urgency  with  which 
they  impressed  me,  compelled  me  to  look  round  in  our 
literature  for  more  than  the  ordinary  text- book  treatment. 
This  I  was  unable  to  find,  except  by  careful  and 
wearisome   plodding    through    masses    of   journals    and 


X  PREFACE  TO  THE  FIRST  EDITION 

periodicals.  Reported  matter  I  found  in  abundance,  but 
it  required  to  be  drawn  up  and  put  into  a  convenient 
space  for  easy  digestion. 

What  I  so  pressingly  needed  myself,  I  judged  others 
would  need  also.  Consequently,  though  the  work  might 
well  have  been  left  to  far  abler  hands  than  my  own,  I 
resolved  to  record  the  result  of  my  readings  and  investi- 
gations, tempered  with  what  experience  I  possessed  my- 
self, in  the  form  this  little  book  presents. 

My  first  intentions  as  to  the  scope  of  this  work  were 
ambitious,  and  I  commenced  it  under  the  title  of  *  The 
Equine  Colics.'  This  I  found  was  far  too  embracing, 
for  it  would  have  led  me  into  a  consideration  and  de- 
scription of  ailments  that  have  been  ably  dealt  with 
elsewhere — e.g.,  the  colic  of  hernia,  the  colic  due  to 
parasites,  etc. 

Finally,  the  title  that  now  heads  the  book  was  selected. 
It  will  limit  me  to  a  consideration  of  those  disorders  with 
which  I  feel  myself  competent  to  deal. 

Regarding  the  imperfections  the  book  contains,  they 
can  be  apparent  to  no  one  more  than  the  author.  The 
very  failings  of  a  work,  however,  will  often  set  going  a 
wheel  of  discussion  and  thought  that  no  amount  of  fore- 
sight could  otherwise  initiate.  That  being  so,  I  am 
content  to  leave  it. 

Lastly,  I  am  to  confess  the  source  whence  I  gained 
my  materials.  That  duty  is  easy.  I  have  not  scrupled 
to  avail  myself  to  the  uttermost  of  anything  I  have 
heard  or  read.  The  man  who  sits  himself  down  to  write 
an  original  work,  unless  it  be  one  of  fiction,  is  handi- 
capped at  the  very  outset.  The  knowledge  he  is  already 
possessed  of  he  largely  owes  to  former  brains  and  other 
people's  experiences.  In  medicine  he  is  bound  to  pro- 
visionally accept  what  greater  minds  than  his  own  have 


PREFACE  TO  THE  FIRST  EDITION  xi 

been  for  generations  establishing.  If  by  one  iota  he 
can  add  to  the  knowledge  already  accumulated,  he  is  a 
lucky  man. 

My  plagiarism  confessed,  I  feel  no  need  to  publish  a 
list  of  the  literature  to  which  I  am  indebted.  I  would, 
however,  particularly  like  to  mention  two  names  :  The 
first,  that  of  William  Percivall,  whose  writings  have 
fallen  into  an  obscurity  they  certainly  do  not  deserve  ; 
the  second,  Veterinary-Colonel  Fred  Smith,  from  whose 
works  I  have  very  largely  drawn,  and  whose  contribu- 
tions to  this  and  alHed  subjects  have  been  such  as  to 
place  the  veterinary  profession  under  a  deep  debt  of 
gratitude. 

I  would  also  mention  that  the  courtesy  of  Sir  John 
M'Fadyean  enables  me  to  reprint  from  the  Journal  of 
Comparative  Pathology  and  Therapeutics  an  article  of  my 
own  that  now  forms  the  subject-matter  of  Chapter  IX. 
Professor  Macqueen  has  kindly  allowed  me  to  make 
use  of  his  valuable  experiments  concerning  the  opera- 
tion of  laparo-enterotomy,  and  Mr.  E.  R.  Harding,  of 
Salisbury,  has  furnished  me  with  his  experiences  relating 
to  the  stimulant  treatment  of  intestinal  impaction. 

The  attempt  in  Chapters  IX.,  X.,  and  XI. ^  to  dif- 
ferentiate varieties  of  subacute  intestinal  obstruction 
may  be  regarded  as  the  main  original  portion  of  this 
work.  For  the  present,  I  simply  ask  for  that  a  careful 
reading. 

This  book,  then,  carries  no  pretence  to  being  entirely 
original.  It  is  a  gathering  together  of  observations  that 
other  minds  have  made,  with  just  so  much  of  my  own 
experience  as  would  enable  me  to  weld  the  loose  particles 
into  one  presentable   whole.      I   am  not  without  hopes 

1  In  this,  the  second  edition,  these  are  now  Chapters  IX,,  XI., 
and  XII.— H.  C.  R. 


xii  PREFACE  TO    THE  FIRST  EDITION 

that  the  manual  will  prove  of  help  to  the  student,  and 
enable  him  to  progress  still  farther  on  the  road  of  inde- 
pendent thought,  upon  the  commencement  of  which  his 
present-day  tutors  so  ably  plant  his  feet. 

To  the  practitioner  I  humbly  trust  this  first  effort  of 
my  pen  will  prove  welcome.  I  ask  him  for  his  in- 
dulgence, and  beg  of  him  to  remember  that  these  pages 
were  vvritten  in  the  moments  of  leisure  afforded  by  a  busy 
country  practice.  Should  it  be  the  means  of  bringing 
together  such  facts  as  will  give  the  veterinarian  a  more 
accurate  and  dependable  knowledge  of  the  subjects  under 
consideration,  the  main  object  of  the  book  will  be 
fulfilled. 

H.  C.  R. 

Spalding, 

October,  igo2. 


COiNTENTS 

CHAPTER  PAGE 

I.    *  COLIC,'    ITS    DEFINITION               -                 .  -I 

II.    SURGICAL    ANATOMY    OF    THE    ABDOMEN  -            6 

III.  HOW    TO    EXAMINE    THE    PATIENT               -  -          21 

IV.  ETIOLOGY  :    GENERAL    PREDISPOSING    CAUSES  -         28 

V.  etiology:  general  exciting  causes  -       35 

VI.  gastric  impaction  (gorged  stomach,  grass 

staggers,  or  stomach  staggers)  -       47 

VII.  gastric  tympany  (gastrectasis,  or  dilata- 

•     tion  of  the  stomach)       -  -  -52 

viii.  rupture  of  the  stomach  (gastrorrhexis)        73 
IX.  subacute  obstruction  of  the  double  colon 
(impaction  of  the  intestines,  impaction 
of  the  colon,  stoppage  of  the  bowels)       80 

X.    subacute       OBSTRUCTION        OF       THE       PELVIC 

FLEXURE    OF   THE    DOUBLE    COLON     -  -123 

XI.    SUBACUTE  OBSTRUCTION  OF  THE  SINGLE  COLON       1 37 
XII.    SUBACUTE  OBSTRUCTION  OF  THE    SMALL    INTES- 
TINES ,  -  .  .  -       14^ 
XIII.    INTESTINAL    IRRIGATION    IN    OBSTRUCTIONS    OF 

THE    COLON  -  -  -  -  -       161 

XIV.    THE      SURGICAL      TREATMENT      OF      INTESTINAL 

OBSTRUCTIONS  -  -  -  '       '' 7 3 

xiii 


xiv  CONTENTS 

CHAPTER  I'AGE 

XV.    INTESTINAL  TYMPANY  (wiND  COLIC,  FLATULENT 

COLIC,    HOVEN,    TYMPANITES,    ETC.)   -                  -  1 89 
XVI.    ENTERITIS    (INFLAMMATION    OF    THE    BOWELS)   -  200 
XVII.    SUPERPURGATION              -                   -                   -                  -  212 
XVIII.    THE     TREATxMENT     OF     COLIC     IN    YOUNG,     UN- 
BROKEN   ANIMALS      -                  -                   -                   -  219 

APPENDIX  : 

I.    THE     COMPOSITION     OF     VARIOUS      FOODS  : 

DIGESTIVE   COEFFICIENTS    OF    FOODS         -       228 
U.    THE     USE     AND    ABUSE    OF    SEDATIVES     IN 

THE  TREATMENT  OF  THE  EQUINE  COLICS       235 
III.    FURTHER  REMARKS  ON  THE  USE  OF  ALOES 
IN      THE     TREATMENT     OF      INTESTINAL 
IMPACTIONS  -  -  -  -       251 


LIST    OF    ILLUSTRATIONS 

FIG.  I'AGE 

1.  SURGICAL    REGIONS    OF    THE    ABDOMEN       -                  -  7 

2.  LONGITUDINAL  SECTION  OF  STOMACH  AND  PYLORUS  lO 

3.  PHOTOGRAPH  OF   STOMACH  TO    ILLUSTRATE    FIG.  2  I  1 

4.  SUPERFICIAL    OR    EXTERNAL    MUSCULAR    COAT    OF 

STOMACH              -                  -                 -                 -                 -  17 

5.  MIDDLE    MUSCULAR    COAT    OF    STOMACH     -                  -  18 

6.  INTERNAL  OR  DEEP  MUSCULAR  COAT  OF    STOMACH  1 9 

7.  KNISELY's    STOMACH-TUBE                   -                  -                  "  7^ 

8.  THE    NORMAL    DOUBLE    COLON         -                  -                  -  1 24 

9.  VOLVULUS      OF      THE      PELVIC      FLEXURE      OF      THE 

DOUBLE    COLON                  -                 -                 -                  -  1 26 

10.  THE    SAME,    WITH    THE  COLON   PULLED    OUT  FROM 

THE    ABDOMEN    AND    EXTENDED                 -                  -  1 27 

11.  IMPACTED    PORTION   OF  SMALL  COLON    SUSPENDED 

BY    MESENTERY                  -                  -                  -                  -  1 68 

12.  SEAT      OF      LAPARO  -  ENTEROTOMY      (mACQUEEN'S 

operation)      -             -             -             -             -  177 

13.  OPERATION    WOUND    (lAPARO-ENTEROTOMY)              -  1 78 

14.  LEMBERT's    sutures    (in    SMALL    COLON)  -                  -  180 

15.  CALCULUS       OBSTRUCTING       SMALL      COLON       (MR. 

harding's  case)          -             .             -             -  187 


THE   COMMON    COLICS   OF 
THE    HORSE. 

CHAPTER  1 
XOLIC  ITS  DEFINITION 

Concerning  a  disorder  that  has  been  recognised  and 
treated  for  years  beyond  the  memory  of  man,  one  would 
imagine  that  its  name,  and  what  that  name  conveyed, 
would  be  well  known  and  understood.  Such,  however, 
is  not  the  case. 

The  word  '  colic  '  is  derived  from  the  Latin  colicus  or 
the  Greek  kolikos,  signifying  the  colon,  and,  strictly  em- 
ployed, means  a  painful,  spasmodic  affection  of  the 
intestines,  especially  of  the  colon.  Far  from  retaining 
such  a  simple  signification,  colic,  in  the  horse,  has  for  a 
long  time  served  to  designate  innumerable  and  widely 
differing  diseases,  whose  only  point  in  common  has  been 
the  evidence  of  abdominal  pain.  The  term  must 
necessarily  be  most  vague  when  it  attempts  to  offer  any 
explanation  of  a  particular  case  in  which  the  symptoms 
are  most  largely  those  of  pain  in  the  abdomen.  If  we 
use  the  word  in  its  most  restricted  sense,  it  should  mean 

I 


2  THE  COMMON  COLICS  OF  THE  HORSE 

only  pain  in  the  bowels,  or  enteralgia.  This  is  an 
abnormal  sensibility  in  the  region  of  the  plexus  mesen- 
tericus,  and,  as  such,  is  not  often  observed  in  our  patients. 
In  the  widest  possible  acceptation  of  the  term,  colic  will 
indicate — apart  from  this  enteralgia — all  painful  affecticns 
of  the  intestines  which  are  not  consequent  upon  inflam- 
mation or  textural  change  of  the  bowel  walls. 

It  is  quite  plain  that  our  first  duty  should  be  to 
tabulate,  as  far  as  possible,  the  different  morbid  condi- 
tions that  may  give  rise  to  colic — using  the  word  in  its 
widest  sense.  This  has  already  been  done  by  that 
eminent  and  conscientious  clinical  observer,  Professor 
Friedberger,  of  Munich.  In  his  pamphlet,  '  Die  Kolik 
der  Pferde,  Sechs  Klinische  Vortrage,'  he  gives  this  table : 

1.  True  Colic,  proceeding  from  the  intestinal  canal, 

and  stomach} 

2.  False  Colic,  arising  from  a  diseased  state  of  the 
other  abdominal  organs.  (Under  this  heading  will  come 
especially  affections  of  the  bladder  and  sexual  organs, 
which  give  rise,  in  the  first  instance,  to  similar  external 
evidences  of  suffering.) 

True  Colic  is  then  taken  and  subdivided  in  the  follow- 
ing manner : 

1  The  addition  of  the  words  'and  stomach'  is  my  own.  Much 
though  I  dislike  to  interfere  with  the  arrangement  tabulated  by 
Professor  Friedberger,  I  cannot  help  but  think  that  stomach 
troubles  should  be  included  under  the  heading  of  True  Colic. 
Following  the  strict  letter  of  all  accepted  definitions,  I  know  it 
should  be  omitted.  Nevertheless,  the  close  manner  in  which  many 
of  the  symptoms  proceeding  from  the  stomach  simulate  those 
arising  from  the  intestinal  canal,  with  the  fact  that  anomalies  of  the 
former  tend  to  the  production  of  disorders  of  the  latter,  points 
conclusively  to  the  necessity  of  carefully  considering  stomach 
ailments  when  treating  of  those  of  the  intestines. — H.  C.  R. 


'COLIC,'  ITS  DEFINITION  3 

A.  Essential,  to  which  may  be  referred  the  under- 
mentioned causes : 

1.  Colic  without   material    cause,    as   the   so-called 

nervous  cramp  (or  rheumatic  colic). 

2.  Colic  consequent  upon  anomalies  of  the  intestinal 

contents.     Such  are : 

{a)  CoHc  produced  by  overfeeding. 

(h)  Colic  brought  on  by  flatulence  (wind  colic). 

{c)  The  colic  occasioned  by  stoppages  in  the 
intestinal  canal.  These  obstructions 
may  arise  from  faecal  accumulations, 
stones,  concretions,  etc. 

B.  Symptomatic.     Such  are  : 

1.  The  coHc  produced  by  worms. 

2.  The  colic  resulting  from  poisons. 

3.  Colic    brought    on    by    structural    disease    and 

changes  in  the  relative  position  of  the 
intestines;  colic  occasioned  by  acute  catarrh 
and  croup  affecting  the  delicate  mucous 
membrane  of  the  colon  ;  colic  from  carbun- 
cular  formations  on  the  mucous  membrane; 
colic  from  dysentery,  and  from  so-called 
internal  cramp ;  coHc  from  wounds  of  the 
stomach  and  entrails,  and  colic  from  spon- 
taneous laceration  or  perforation  of  those 
organs. 

4.  Colic  resulting  from   morbid   conditions   of   the 

abdomen  and  the  covering  of  the  intestines 
(peritoneum). 

A  mere  perusal  of  this  extensive  and  complete  classi- 
fication of  the  varieties  of  colic  will  serve  to  impress  upon 
us  the  absolute  necessity  of  looking  for  much  more  than 
the  mere  exhibition  of  pain  on  the  part  of  our  patient  in 

I — 2 


4  THE  COMMON  COLICS  OF  THE  HORSE 

order  to  arrive  at  a  diagnosis  that  will  approach  with  any 
degree  of  accuracy  to  the  truth. 

The  human  surgeon,  by  clear  and  incisive  reasoning 
deduced  from  the  symptoms  observed  by  himself  and  th  e 
help  afforded  him  by  his  patient,  has  the  power  of  making 
such  subtle  distinctions  in  the  different  varieties  of  colic 
as  to  render  his  skill  in  diagnosis  an  object  of  admiration 
to  the  veterinarian. 

One  word  of  warning  is  necessary  to  the  animal  surgeon. 
His  admiration  of  the  human  physician's  diagnosis  must 
not  lead  him  to  follow  blindly  those  symptoms  and  treat- 
ments laid  out  in  medical  literature. 

I  am  well  aware  that  in  very  many  diseases  there  is 
an  extremely  close  analogy  between  the  veterinary  and 
human  patient,  both  in  regard  to  the  symptoms  and  the 
treatment.     That,  however,  is  not  the  case  with  colic. 

The  ordinary  text-book  on  human  medicine  seldom 
devotes  more  than  a  few  pages  to  its  consideration.  Its 
treatment,  unless  it  be  the  colic  due  to  hernia  or  other 
equally  serious  cause,  is  comparatively  simple,  and 
occasions  the  physician  no  alarm.  He  administers  an 
opiate,  and,  where  occasion  demands,  combines  the 
sedative  with  a  brisk  purgative. 

That  done,  the  case  is  comfortably  dismissed  from  his 
mind.  He  is  not  unduly  anxious  about  pains  whose 
continuance  is  spread  over  three  or  four  days—  nay,  even 
weeks. 

Compare  that  with  the  twelve  to  forty-eight  or  sixty 
hours  of  anxious  watching  that  so  often  falls  to  the  lot  of 
the  veterinarian — a  two  days'  hurried,  anxious  solicitude 
into  which  is  crammed  the  diagnosis  and  treatment  of 
three  weeks.  To  illustrate  my  point,  compare  the  cases 
of  intestinal  obstruction  in  the  horse  and  the  human 
patient. 


'  colic;  its  definition  $ 

Owing  to  circumstances  which  I  shall  endeavour  to 
explain  in  a  future  chapter,  one  day's  illness  in  the  horse 
is  practically  of  the  same  length  as  a  week's  suffering 
from  the  same  ailment  in  man.  The  veterinarian  is  com- 
pelled to  crowd  into  one  day  a  diagnosis  and  treatment 
that  the  human  medico  may  methodically  and  easily 
arrive  at  by  a  week's  careful  study  of  the  symptomatology 
and  history  furnished  by  his  patient. 

This  apparent  digression  is  really  a  lengthening  of  the 
definition  ;  it  is  inserted  for  this  reason.  I  desire  to 
indicate  as  forcibly  as  lies  within  me  one  fact — human 
and  equine  colic  in  no  material  way  bear  likeness  one 
to  the  other.  My  excuse  for  trespassing  so  far  into  the 
domain  of  human  medicine  in  connection  with  this  point 
is  this  :  I  have  so  frequently  seen  veterinarians  attempt- 
ing to  base  their  treatment  on  knowledge  derived  from 
medical  literature  referring  to  man.  I  feel  sure  that 
nothing  could  lead  them  further  from  the  truth. 

'  Colic,'  so  long  as  the  horse  exists,  will  always  have  a 
terrible  significance  for  the  practitioner  of  veterinary 
medicine.  It  still  continues,  in  many  of  its  aspects,  to 
baffle  the  most  careful  and  painstaking  observer.  It  still 
claims  annually  many  thousands  of  victims.  Anthrax, 
tuberculosis,  and  other  dire  disorders  still  persist  in 
carrying  off  their  spoils,  but  it  is  doubtful  to  my 
mind  whether  any  other  ailment  in  the  whole  cate- 
gory of  veterinary  diseases  is  accountable  for  more  loss, 
more  anxiety,  and  more  self-scourging  than  is  '  colic' 


CHAPTER  II 

SURGICAL  ANATOMY  OF  THE  ABDOMEN 

A  THOROUGH  knowledge  of  the  regional  anatomy  of  the 
abdomen  is  absolutely  essential  to  the  determination  of  a 
definite  diagnosis.  The  man  who  has  strongly  insisted 
upon  that,  and  devoted  an  enormous  amount  of  time 
and  thought  to  the  subject,  is  Lieutenant-General  Fred 
Smith.  It  is  the  result  of  his  work  that  forms  the 
subject-matter  of  the  present  chapter,  and  I  take  this 
opportunity  of  thanking  him  for  his  kindness  in  allowing 
me  to  incorporate  it  with  this  volume.  In  his  letter 
granting  me  permission  to  use  it  he  says :  *  The  infor- 
mation in  these  few  pages  represents  an  immense  amount 
of  work.  I  do  not  remember,  now,  how  many  dissections 
I  made  in  the  upright  position,  but  a  large  number.' 
***** 
For  surgical  purposes  the  abdomen  is  best  divided 
into  a  superior  and  inferior  zone  by  a  line  drawn  horizon- 
tally from  the  hip-joint  to  the  ribs.  These  zones  are 
further  subdivided  into  three  parts  by  means  of  two 
vertical  lines  carried  round  the  abdomen,  one  from  the 
body  of  the  first  lumbar  vertebra,  and  the  other  passing 
just  in  front  of  the  antero-inferior  spinous  process  of  the 
ilium.  By  these  means  we  have  the  abdomen  mapped 
out  into  a  superior  and  inferior  zone,  and  each  zone  into 

6 


SURGICAL  ANATOMY  OF  THE  ABDOMEN  7 

an  anterior,  middle,  and  posterior  region  ;  but  in  order  to 
prevent  confusion  we  will  number  these  regions —thus, 
the  anterior,  middle,  and  posterior  regions  of  the  superior 
zone  will  be  i,  2,  3,  whilst  the  same  regions  of  the 
inferior  zone  will  be  4,  5,  6  (see  Fig.  i).  Regions  i,  2, 
and  3  would  be  respectively  the  superior  diaphragmatic, 
lumbar,  and  pelvic  regions,  whilst  4,  5,  and  6  would  be 
the  inferior  diaphragmatic,  lumbar,  and  pelvic  regions. 
The  largest  region  is  the  inferior,  and  the  smallest  the 


Fig,  I. — Surgical  Regions  of  the  Abdomen. 

I,  Superior  diaphragmatic  ;  2,  superior  lumbar;  3,  superior  pelvic  ; 

4,  inferior  diaphragmatic ;  5,  inferior  lumbar  ;  6,  inferior  pelvic. 

superior  diaphragmatic.  We  shall  find  these  landmarks 
of  great  use  to  us  in  studying  the  relation  of  the  viscera 
to  its  walls. 

The  cavity  of  the  abdomen  is  nearly  ovoid  ;  its  long 
axis  is  directed  obliquely  from  above  downwards  and 
forwards  ;  it  is  bounded  anteriorly  by  the  diaphragm, 
posteriorly  by  the  pelvis,  laterally  and  inferiorly  by  its 
walls,  and  superiorly  by  the  lumbar  portion  of  the  spine. 
In  order  to  thoroughly  comprehend  the  arrangement 
of  the  abdominal  viscera,  it  is  absolutely  necessary  to 
bear  in  mind  the  direction  of  this  cavity  and  that  of  the 
diaphragm. 


8  THE  COMMON  COLICS  OF  THE  HORSE 

The  Peritoneum. — The  parietal  layer  is  very  loosely 
attached  to  the  abdominal  walls,  which  fact  constitutes 
an  important  practical  point  in  connection  with  opera- 
tions performed  in  its  vicinity.  The  parietal  portion 
occasionally  forms  part  of  a  hernial  sac,  but  not  always, 
as  owing  to  its  slight  elasticity  it  more  often  ruptures. 
The  posterior  surface  of  the  bladder  and  a  portion  of  the 
rectum  and  vagina  are  all  uncovered  by  peritoneum — 
points  to  be  remembered  in  connection  with  the  surgery 
of  these  parts. 

The  Stomach  presents  several  details  of  great  sur- 
gical importance :  its  small  size,  the  presence  of  an 
arrangement  usually  preventing  vomition,  its  position  in 
the  abdomen,  and  its  shape,  are  all  points  of  great  interest 
to  us,  and  have  a  direct  bearing  on  many  of  the  diseases 
affecting  it.  It  is  situated  in  the  left  hypochondrium, 
but  under  distension  extends  into  the  epigastric  and 
right  hypochondriac  regions.  The  organ  is  suspended 
from  left  to  right  (cardia  to  pylorus),  obliquely  down- 
wards, with  the  lesser  curvature  looking  towards  the 
right  side;  the  stomach  is  situated  principally  to  the 
left  of  the  spine,  in  apposition  with  the  diaphragm,  and 
extends  from  near  the  last  ribs  on  the  left  side  to  the 
upper  surface  of  the  colon  on  the  right  half  of  the  body. 
To  the  right  it  is  in  contact  with  the  liver,  the  left 
extremity  being  in  apposition  with  the  spleen,  diaphragm, 
left  kidney,  and  left  prerenal  capsule,  whilst  inferiorly  it 
rests  on  the  double  colon  at  the  sternal  curve,  which 
prevents  the  stomach,  no  matter  what  its  state  of  dis- 
tension may  be,  from  ever  being  in  actual  contact  with  the 
abdominal  walls.  The  oesophagus  enters  the  stomach  at 
the  lesser  curvature,  and,  owing  to  the  peculiarity  of  its 
arrangement,  prevents,  under  ordinary  circumstances, 
anything  from  passing  through  it  in  the  reverse  direction. 


SURGICAL  ANATOMY  OF  THE  ABDOMEN  9 

The  cardiac  extremity  of  the  oesophagus  is  very  thick, 
the  opening  into  the  stomach  small  and  filled  with  the 
folds  of  mucous  membrane  lining  it,  and  the  cardia 
itself  surrounded  by  muscular  fasciculi  producing  a 
powerful  occlusion  of  the  orifice.  It  is  owing  to  these 
causes  that  the  horse  is  usually  unable  to  vomit. 

From  careful  dissection  I  have  found  the  following 
to  be  the  arrangement  of  the  cardiac  fibres  :  Around  the 
cardia  and  left  extremity  of  the  stomach  are  three  layers 
of  muscular  fibres — (i)  the  external,  running  towards  the 
pylorus  and  also  over  the  left  cul-de-sac  ;  (2)  the  middle, 
running  round  the  cardia,  being  a  continuation  of  the 
circular  fibres  of  the  oesophagus,  and  very  thick  at  the 
portion  situated  in  the  lesser  curvature ;  (3)  the  internal, 
running  in  the  direction  of  the  long  axis  of  the  organ, 
passing  as  a  loop  round  the  left  side  of  the  cardia, 
but  leaving  the  right  side,  or  that  portion  situated  within  the 
lesser  curvattire,  zvithoiit  fibres.  It  is  this  layer,  in  conjunc- 
tion with  the  middle  layer,  which  forms  the  so-called 
sphincter,  for,  owing  to  the  arrangement  of  the  fibres, 
the  cardia  is  compressed  on  the  left  towards  the  right  by 
the  (looped  fibres  of  the)i  internal  layer,  and  on  the 
right  towards  the  left  by  the  middle  layer.  The  pyloric 
extremity  of  the  stomach  is  supplied  with  a  sphincter, 
the  so-called  pyloric  ring. 

We  believe  that,  in  addition  to  the  resistance  offered 
to  vomition  by  the  cardia,  the  contraction  of  the 
oesophagus  (at  least,  the  posterior  half  of  it)  materially 
assists  in  preventing  anything  passing  along  it  in  the 
reverse  direction,  for  we  always  find  that  where  dilatation 
of  the  cardia  has  occurred  so  as  to  allow  vomition  the 
oesophagus  is  likewise  dilated  and  its  walls  are  flaccid. 

On  examining  a  stomach  and  oesophagus  after  death, 
*  The  insertion  in  brackets  is  mine.— H.  C.  R. 


lo  THE  COMMON  COLICS  OF  THE  HORSE 

in  a  case  where  vomiting  has  occurred  during  life,  we 
find  the  parts  flaccid  and  easily  dilatable ;  the  fingers 
may  be  introduced  with  freedom  into  the  cardia,  the 
lining  membrane  of  the  oesophagus  is  no  longer  in 
apposition,  and  on  dividing  the  gullet  for  the  purpose  of 
removing  the  stomach,  no  matter  how  far  forward  it 
is  cut,  the  fluid  contents  of  the  viscus  (that  is,  if  this 
organ  be  entire)  will  pour  out.  In  a  case  of  epilepsy 
which  occurred  in  my  practice,  I  found  after  death, 
although  there  had   been  no  vomiting  during   life,  the 


Fig.  2.— Longitudinal  Section  of  Stomach  and  Pylorus. 

a,  Opening  of  cardia  ;  b,  pylorus  ;  c,  commencement  of 

duodenum  ;  d,  pyloric  or  duodenal  '  trap,' 

cardia  and  oesophagus  in  this  condition.  The  cardiac 
and  pyloric  orifice  of  the  stomach  are  not  far  apart ;  the 
pyloric  is  below  the  cardiac.  A  very  singular  and 
important  arrangement  of  the  pylorus  and  duodenum 
exists ;  dissection  reveals  that  the  duodenum,  where  it 
commences  at  the  pylorus,  is  S-shaped  and  much  dilated, 
forming  an  arrangement  not  at  all  unlike  an  S-trap  used 
in  drain-pipes  (see  Figs.  2  and  3).  This  direction  of  the 
duodenum  appears  to  regulate  the  pace  at  which  the 
ingesta  should  pass  through ;  as  soon  as  the  trap  is 
formed,  the  duodenum  ascends  towards  the  spine  lying 


SURGICAL  ANATOMY  OF  THE  ABDOMEN  ii 

all  the  while  on  the  colon.  It  is  easy  to  see  how  simple 
it  is  for  a  distended  stomach  and  intestines  to  press  upon 
the  pyloric  trap,  and  practically  occlude  it;  this  is  the 
second  factor  in  producing  ruptured  stomach. 

The  Small  Intestines  are  divided  by  the  anatomists 


Fig,  3. — Photograph  of  Stomach  to  illustrate  Fig.  2.^ 

a,  (Esophagus  ;  b,  pylorus  ;  c,  commencement  of  duodenum  ; 

d,  pyloric  or  duodenal  '  trap. ' 

of  the  present  day  into  two  portions,  the/ixed  or  duodenal 
and  fro  or  floating;  they  are  about  70  feet  in  length. 
The  duodenal  portion  commences  from  the  pylorus, 
passes  under  the  concave  surface  of  the  liver  in  a  direc- 
tion upwards  and  outwards,  lying  on  the  double  colon 

^  I  have  inserted  this  photograph  to  illustrate  General  Smith's 
diagram.  The  stomach  was  removed  from  the  abdomen,  and  the 
duodenal  £-trap  carefully  arranged  as  it  lies  in  situ, — H.  C.  R. 


12  THE  COMMON  COLICS  OF  THE  HORSE 

and  passing  in  apposition  with  the  last  rib,  where  it  may 
readily  be  found  at  the  lower  part  of  its  upper  third,  just 
where  the  extremity  of  the  transverse  processes  of  the 
first  lumbar  vertebra  reaches  ;  it  then  passes  immediately 
behind  the  right  kidney  opposite  to  the  second  lumbar 
vertebra,  crossing  the  spine  transversely  behind  the 
anterior  mesenteric  artery ;  it  is  then  attached  to  the  colon, 
and  terminates  in  becoming  continued  by  the  floating 
portion  in  the  left  flank.  Where  the  duodenum  rests  on 
the  colon  and  passes  under  the  last  ribs  on  the  right  side 
is  a  practical  point  of  considerable  importance. 

The  free  portion  of  the  small  intestines  is  suspended 
by  means  of  the  mesentery  from  the  underneath  portion 
of  the  spine  in  a  spiral  form  ;  owing  to  the  length  of  the 
mesentery  and  this  mode  of  attachment,  volvulus  of  the 
bowels  is,  unfortunately,  only  too  common.  The  small 
intestines  hang  well  in  the  centre  of  the  body,  and  lie  in 
the  curve  formed  by  the  double  colon  ;  they  terminate  at 
the  caecum,  crossing  to  the  right  side  for  this  purpose, 
and  opening  into  the  gut  close  to  the  colon,  but  below  it. 
This  part  is  situated  beneath  the  third  lumbar  vertebra, 
about  6  inches  from  its  under  surface. 

The  Large  Intestines  are  represented  by  the  caecum, 
colon,  and  rectum  ;  they  occupy  a  fairly  regular  position, 
and  a  knowledge  of  their  disposition  and  course  is  im- 
perative. The  ccecimi,  or  'blind  gut,'  contains,  on  an 
average,  about  8  gallons  of  fluid,  and  is  over  3  feet 
in  length.  It  usually  occupies  a  position  obliquely  from 
above  downwards  and  forwards,  and  presents  superiorly 
a  base,  and  inferiorly  an  apex.  The  superior  extremity, 
base,  or  arch,  or,  as  well  designated  by  Chauveau, 
'crook,'  is  situated  in  the  right  lumbar  region  close 
under  the  spine  ;  it  is  in  relation  with  the  right  kidney, 
duodenum,  psoas  muscles,  colon,  small    intestines,  and 


SURGICAL  ANATOMY  OF  THE  ABDOMEN  13 

pancreas.  The  crook  or  arch  looks  forwards,  and  in 
the  concavity  of  the  curve  on  its  inside  the  small  in- 
testine opens  and  the  colon  begins.  The  inferior  ex- 
tremity is  placed  within  the  double  colon  at  its  sternal 
curve,  the  apex  resting  on  the  ensiform  cartilage  of  the 
sternum  ;  at  least,  this  is  its  usual  position.  The  colon  is 
divided  into  two  portions,  the  single  and  double ;  it  is 
about  12  feet  in  length.  For  convenience  of  description 
the  double  colon  is  divided  into  four  parts  ;  commencing 
from  the  crook  of  the  caecum  it  proceeds  forwards  and 
downwards,  passing  beneath  the  right  kidney  (having  the 
pancreas  between  it  and  that  organ)  to  the  diaphragm, 
and,  bending  to  the  left,  forms  its  suprasternal  flexure  ;  the 
second  portion  is  continued  from  here,  running  backwards 
and  upwards  into  the  left  flank,  turning  inwards  opposite 
the  pelvis  and  close  up  against  the  spine  to  form  the  pelvic 
HexHve  ;  now  follows  the  third  portion,  running  forwards 
above  the  second  and  attached  to  it  by  peritoneum  :  when 
it  reaches  the  diaphragm  it  makes  a  curve  to  the  right, 
the  diaphyagmatic  flexure,  followed  by  the  fourth  portion, 
which  is  attached  by  peritoneum  to  the  first,  and  reaches 
posteriorly  to  the  base  of  the  caecum,  where  it  terminates 
in  the  single  colon.  This  crosses  to  the  left  side  beneath 
the  first  lumbar  and  last  dorsal  vertebrae,  being  attached 
by  peritoneum  to  the  crura  of  the  diaphragm  and  the 
mesenteric  vessels.  The  double  colon  at  its  origin  is 
very  small,  but  it  quickly  enlarges,  and  at  the  supra- 
sternal flexure  is  of  considerable  size  ;  at  its  pelvic  curve 
it  is  greatly  reduced  in  volume,  but  at  the  diaphragmatic 
flexure  it  again  enlarges,  and  close  to  where  it  terminates 
in  the  single  colon  attains  its  largest  size,  and  then  suddenly 
contracts  to  form  the  single  colon.  These  differences  in 
the  volume  of  the  colon  are  of  direct  practical  interest. 
The  pelvic  curvature  and  the  single  colon  are  the  most 


14  THE  COMMON  COLICS  OF  THE  HORSE 

frequent  seats  of  obstruction  from  calculi,  gravel,  etc. 
which  have  passed  with  ease  along  the  more  dilated 
portion  of  the  canal. 

The  Single  Colon  lies  in  the  left  flank,  is  suspended 
from  the  spine  by  peritoneum,  and  extends  to  the  pelvis, 
where  it  becomes  continuous  with  the  rectum. 

The  Liver  is  situated  principally  in  the  right  hypo- 
chondriac region,  and  is  placed  obliquely  from  above 
downwards  from  right  to  left.  Its  anterior  face  is  applied 
against  the  diaphragm,  its  posterior  against  the  stomach 
and  intestines.  The  upper  extremity  of  the  right  lobe  is 
in  apposition  with  the  right  kidney  at  the  space  between 
the  sixteenth  and  seventeenth  ribs  ;  from  here  the  liver 
extends  downwards,  inwards,  and  forwards,  having 
between  it  and  the  costal  walls  the  posterior  lobe  of  the 
right  lung  and  the  diaphragm,  and  passing  across  the 
abdomen  its  middle  lobe  rests  on  the  sternum.  The 
right  lobe  extends  as  far  forwards  as  about  opposite  the 
eleventh  rib,  as  far  back  as  the  sixteenth  or  seventeenth, 
and  reaches  as  low  down  as  the  inferior  part  of  the  middle 
third  of  the  ribs.  It  is  important  to  remember  that, 
excepting  at  one  small  part  (between  the  sixteenth  and 
seventeenth  ribs),  the  right  lung  and  diaphragm  are 
always  between  us  and  that  organ,  an  anatomical  fact 
which  renders  percussion  almost  useless  in  liver  disease. 

The  Spleen  is  situated  on  the  left  side  of  the  abdomen  ; 
it  is  attached  superiorly  to  the  left  kidney  and  prerenal 
capsule,  and  anteriorly  by  peritoneum  to  the  greater 
curvature  of  the  stomach.  The  base  of  the  organ  extends 
to  two  or  three  inches  behind  the  middle  third  of  the  last 
rib  on  the  left  side. 

The  Pancreas  is  situated  on  the  double  colon,  to  the 
right  side  of  the  spine.  At  its  upper  part  it  is  beneath 
the  right  kidney  and  close  against  the  vena  cava.     Its 


SURGICAL  ANATOMY  OF  THE  ABDOMEN  15 

anterior  border  is  in  contact  with  duodenum  and  the 
the  lesser  curvature  of  the  stomach. 

The  Kidneys. — The  right  has  its  anterior  border 
reaching  as  far  forward  as  the  sixteenth  rib,  where  it  is 
in  apposition  with  the  liver  ;  its  posterior  extends  back 
to  the  first  lumbar  vertebra,  its  inferior  edge  as  low  as 
the  middle  third  of  the  last  rib  but  one.  To  the  posterior 
part  of  this  gland  the  base  of  the  caecum  is  attached. 
The  renal  artery  penetrates  the  organ  immediately  under 
the  last  rib.  The  left  kidney  has  its  anterior  border 
reaching  only  as  far  forward  as  the  last  rib,  its  posterior 
to  the  transverse  process  of  the  third  lumbar  vertebra.  It 
lies  up  much  closer  to  the  spine  than  its  fellow  on  the 
opposite  side. 

A  knowledge  of  the  situation  and  position  of  the  various 
abdominal  organs  is  essentially  necessary  to  the  surgeon, 
for  he  may  at  any  time  be  called  upon  to  perform  opera- 
tions in  their  vicinity.  Take,  for  example,  the  simple 
one  of  *  puncturing  the  bowels,'  in  performing  which,  by 
entering  the  trocar  too  high  up  on  the  right  side,  the 
duodenum  or  right  kidney  may  be  wounded,  or  the  left 
side  of  the  spleen  or  the  left  kidney.  Such  serious  com- 
plications, liable  to  arise  out  of  even  a  simple  operation, 
can  only  be  averted  by  a  clear  and  certain  acquaintance 
with  the  anatomy  of  the  viscera.  It  is  particularly 
important  to  know  the  position  they  occupy  in  the  living 
body  ;  having  to  this  end  arbitrarily  divided  the  abdomen 
into  the  various  regions  before  noticed,  we  will  conclude 
this  chapter  by  stating,  in  tabular  form,  the  contents  of 
each. 

Right  Side  of  Abdomen. 

/'Anterior   border    of    right  kidney, 

Region    No.    i,    or    superior  J      prerenal     capsule,    and  supero- 

diaphragmatic.  |      posterior  part    of    right  lobe   of 

\     liver. 


i6 


THE  COMMON  COLICS  OF  THE  HORSE 


Right  Side  of  Abdomen 
{continued) 


Region    No.    2,    or    superior 
pelvic. 


Region   No.    3,    or    superior 
pelvic. 


Region    No.    4,    or    inferior 
diaphragmatic. 


Region    No.    5,    or    inferior 

lumbar. 
Region    No.    6,    or    inferior 

pelvic. 

Left  Side  of  Abdomen. 
Region    No,    i,    or    superior 
diaphragmatic. 

Region    No.    2,   or    superior 
lumbar. 

Region    No.    3,    or    superior 
pelvic. 


'Posterior  part  of  right  kidney,  the 
base  of  the  caecum,  termination 
of  the  ileum,  commencement  of 
the  double  colon,  part  of  the 
duodenum,  and,  in  the  female, 
the  right  ovary,  and  upper  part 
of  right  horn  of  uterus. 
/The  base  of  the  caecum  when  dis- 

\^     tended. 

The  first  and  fourth  portions  of 
the  double  colon,  part  of  the 
suprasternal  and  diaphragmatic 
flexures,  the  right  and  middle 
lobes  of  the  liver,  the  inferior 
half  of  the  caecum,  the  pancreas, 
portion  of  duodenum,  and  right 
extremity  of  stomach. 


Termination  of  the  double  colon. 


1 

j 

/Portion     of     double     colon, 

\     caecum  when  distended. 


and 


Region    No.    4,    or    inferior 
diaphragmatic. 


Region    No.    5,    or    inferior 
lumbar. 


Region    No.    6,    or    inferior 
pelvic. 


/Portion      of      left      extremity      of 

^     stomach. 
Left  kidney  and  prerenal  capsule, 
base  of  the  spleen,  left  ovary  and 
horn  of  uterus  in   female,  third 
portion  of  double  colon. 

/The  pelvic   flexure   of  the   double 

\     colon. 

/The  second  and  third  portions  of 
double  colon,  the  suprasternal 
and  diaphragmatic  flexures,  the 
greater  curvature  of  the  stomach, 
portion  of  spleen  and  left  lobe  of 
the  liver. 

I  Second  and  third  portion  of  double 
colon,  and  coils  of  small  in- 
testines, part  of  the  single  colon, 
commencement  of  the  rectum, 
and  large  part  of  the  spleen. 
/Pelvic  flexure  of  the  double  colon, 
\     and  coils  of  small  intestines. 


SURGICAL  ANATOMY  OF  THE  ABDOMEN 


17 


Following  this  summary  of  the  regional  anatomy  as 
written  by  General  Smith,  I  wish  here  to  refer  again  to 
the  arrangement  of  the  cardiac  fibres  of  the  stomach. 
Their  arrangement  is  so  striking,  and  of  such  peculiar 
interest  when  we  come  later  to  discuss  gastric  tympany, 
that  I  wish,  if  possible,  to  render  even  more  clear  the 
excellent  description  of  them  he  has  given  us.     To  that 


Fig.  4.— Superficial  or  External  Muscular  Coat  of  Stomach. 
A,  CEsophagus ;  B,  left  sac  ;  C,  right  sac  ;  D,  duodenal  Strap. 


end  I  append  diagrams  to  illustrate  them,  and,  although 
the  matter  arrived  at  is  essentially  the  same  as  that  set 
out  on  p.  9,  dissections  I  have  made  of  the  stomachal 
coats  lead  me  to  put  their  description  into  somewhat 
different  words.     They  run  as  follows  : 

I.  A  Superficial  Plane.— This  is  evidently  a  con- 
tinuation of  the  longitudinal  muscular  layer  of  the 
CESOphagus  (see  Fig.  4).     It  radiates  obliquely  over  the 


1 8  THE  COMMON  COLICS  OF  THE  HORSE 

left  sac,  which  it  completely  covers,  leaving  the  right  sac 
(indicated  by  the  dotted  lines)  uncovered.  In  the  lesser 
curvature  its  fibres  become  somewhat  abruptly  lost,  while 
the  greater  curvature  retains  them  to  the  entire  envelop- 
ment of  the  underneath  surface  of  the  right  sac,  on 
whose  upper  surface  they  become  gradually  obliterated. 


Fig.  5. —Middle  Muscular  Coat  of  Stomach. 

a,  Circular  fibres  (in  one  position  lined  more  blackly  than  their 
neighbours).  There  is  no  aggregation  of  these  fibres.^ 
A,  (Esophagus  ;  B,  left  sac  ;  C,  right  sac  ;  D,  duodenal  S-trap. 

2.  A  Middle  Plane. — The  fibres  of  this  are  again 
a  continuation  of  the  muscular  coverings  of  the  oesophagus 
— viz.,  of  its  circular  coat  (see  Fig.  5).  Running  beneath 
the  fibres  of  the  superficial  plane,  the  middle  coat  also 
envelops  the  whole  of  the  left  sac.  Where  the  fibres  of 
the  superficial  plane  become  indistinct  in  the  position  of 

1  This  darker  lining  is  for  purposes  of  emphasis  only. — H.  C.  R. 


SURGICAL  ANATOMY  OF  THE  ABDOMEN  iq 

the  lesser  curvature  and  the  pyloric  end  of  the  right  sac 
they  appear  on  the  surface,  and  are  there  plainly  visible 
— that  is,  at  the  point  immediately  indicated  by  the  Une  a. 
3.  A  Deep  Plane.— Like  to  the  superficial,  these 
fibres  run  somewhat  obliquely  in  the  direction  of  the 
long  axis  of  the  organ,  wholly  covering  the  left  sac,  and 
leaving  the  right  sac  free. 


D 


i^ 


Fig.  6. — Internal  or  Deep  Muscular  Coat  of  Stomach. 

fl,  A  peculiar  aggregation  of  the  fibres,  clasping  the  cardiac,  end 
of  the  oesophagus  in  the  manner  that  a  cravat  does  the 
neck.  A,  CEsophagus  ;  B,  left  sac  ;  C,  right  sac  ;  D,  duodenal 
S-trap. 

As  I  have  indicated  in  the  diagram  (Fig.  6),  at  the 
point  lettered  a  there  is  a  distinct  ridge-like  aggregation 
of  the  fibres  of  this  coat.  These  closely  embrace  the  end 
of  the  oesophagus  in  the  manner  that  a  cravat  does  the 
neck.     Their  point  of  greatest  aggregation  is  the  left  side 

2—2 


20  THE  COMMON  COLICS  OF  THE  HORSE 

of  the  cesophagus.  On  the  right  side  of  that  canal  (the 
portion  situated  within  the  lesser  curvature)  these  fibres 
are  wholly  wanting. 

A  brief  consideration  of  the  general  arrangement  of 
these  fibres  of  the  stomach  of  the  horse  will  be  sufficient 
to  point  out  that  the  so-called  cardiac  sphincter  is  no 
myth.  Taking  the  two  opposite  sets  of  fibres,  those 
intentionally  darkly  lined  at  a,  Fig.  5,  and  those  of  the 
cravat-shaped  formation  at  a,  Fig.  6,  we  see  at  once  that, 
when  contraction  of  the  muscular  coats  of  the  stomach 
occurs,  the  lower  end  of  the  oesophagus,  just  where  it 
enters  the  stomach,  is  bound  to  be  gripped.  While  it  is 
compressed  from  left  to  right  by  the  fibres  of  the  deep 
coat,  it  is  at  the  same  time  compressed  from  right  to  left 
by  the  fibres  of  the  middle  coat. 

The  sphincter  thus  formed  is  an  extremely  powerful 
one.  Moreover,  it  is  in  constant  operation.  This  explains 
in  great  part,  no  doubt,  how  it  is  that  gases  or  food 
accumulated  in  abnormal  quantity  inside  the  stomach 
gain  practically  no  exit  by  way  of  the  cesophagus.  Save 
in  cases  so  rare  that  their  occurrence  may  be  reckoned  a 
negligible  quantity,  everything  collected  in  the  stomach, 
deleterious  or  otherwise,  is  bound  to  pass  out  by  way  of 
the  pylorus. 

This  one  peculiarity  alone  in  the  build  of  the  horse's 
stomach  must  enormously  influence  the  treatment  of 
several  disorders  we  are  afterwards  to  consider.  For  that 
reason  I  have  given  it  prominence  here. 


CHAPTER  III 
HOW  TO  EXAMINE  THE  PATIENT 

Presumably  a  simple  matter,  this  is,  nevertheless,  a 
subject  that  requires  the  most  careful  consideration. 
When  conducting  an  examination  that  is  to  lead  to  the 
diagnosis  of  a  case  of'  colic,'  it  should  never  be  forgotten 
that  it  is  always  a  case  of  the  greatest  gravity  in  the 
horse. 

On  first  sight,  the  pains  of  colic  may  often  appear  to 
be  of  the  most  simple  character,  and  yet  terminate  fatally 
after  the  expiration  of  a  few  hours.  I  have  repeatedly 
seen  cases  where  the  main  symptoms  on  a  casual 
examination  were  those  that  occasioned  me  no  alarm. 
Nevertheless,  one  hour  afterwards  I  have  foretold  the 
animal's  death.  There  is  not  the  slightest  doubt  that 
the  examination  of  the  patient  should  always  be  of  the 
most  searching  nature.  If  the  examination  is  half- 
hearted and  hasty,  an  entirely  erroneous  opinion  will  be 
arrived  at,  and  the  horse,  as  a  result,  will  suffer. 

Looking  at  the  matter  from  a  purely  selfish  point  of 
view,  the  veterinarian  should  constantly  have  in  mind 
the  value  of  his  reputation.  By  his  clients,  his  standing 
as  a  clever,  shrewd  man  of  medicine  will  always  be 
largely  based  upon  the  correctness  and  precision  of  his 
prognosis  in  the  cases  they  entrust  to  his  care.     As  much 


22  THE  COMMON  COLICS  OF  THE  HORSE 

of  his  precision  in  foretelling  the  termination  of  his  case 
of  colic  will  depend  on  the  thoroughness  of  his  first  in- 
spection, it  is  clear  that  the  manner  of  examination  must 
be  of  the  greatest  importance.  Of  such  importance  have 
I  deemed  it,  that  I  have  devoted  a  chapter  especially  to 
its  consideration. 

In  the  first  place,  I  wish  to  lay  the  greatest  possible 
stress  on  this  fact.  The  examination  must  be  a  lengthy 
one  ;  and  my  advice,  especially  to  the  young  practitioner, 
is  this :  After  your  examination  on  the  lines  laid  down 
in  the  following  paragraphs,  compose  yourself,  at  any 
rate,  for  a  wait  of  half  an  hour. 

From  the  patient  you  have  no  verbal  description  of  the 
seat  of  pain,  neither  have  you  any  information  as  to  its 
character.  Nevertheless,  the  sufferer,  dumb  as  he  is, 
will  show  you  much  if  you  will  but  carefully  watch  him. 
It  is  not  fair  to  suppose  that  the  animal  will  hold  out  for 
your  inspection  all  possible  symptoms  of  his  malady 
during  the  first  five  minutes  you  are  in  his  box.  Con- 
sequently, you  must  watch  him  patiently  until  all  his 
postures  for  affording  himself  relief  have  made  him  run 
the  entire  gamut  of  the  symptoms  that  evidence  his  com- 
plaint. 

This  careful  watching  should  be  followed  by  a  systematic 
mode  of  inspection. 

I .  All  possible  history  concerning  the  attack  should 
be  obtained  from  the  owner  or  the  attendant.  The 
length  of  time  the  animal  has  suffered,  the  nature  of  his 
food,  the  manner  of  his  attack,  whether  ushered  in  by 
shivering  attacks  or  not,  the  nature  of  the  water-supply, 
what  emergency  medicine  has  been  administered,  whether 
previously  at  work  or  rest,  whether  a  quick  or  slow 
feeder,  etc.,  are  all  important  points  in  making  the  first 
inquiry. 


HOW  TO  EXAMINE  THE  PATIENT  23 

2.  A  rapid  glance  over  the  animal  should  next 
occupy  the  veterinarian  before  attempting  to  handle  his 
patient.  This  generally  reveals  some  special  symptom 
that  the  animal  will  not  show  so  well  when  he  gives 
himself  up  to  control. 

More  especially  is  this  latter  advice  to  be  followed 
when  the  patient  is  a  young,  unbroken  colt,  or  an  animal 
of  an  excitable,  nervous  temperament.  Such  patients, 
directly  man  commences  interference,  seem  to  possess 
the  power  of  hiding  the  intensity  of  the  pain  they  are 
suffering,  and  to  stand  so  quietly  as  to  fully  deceive  the 
rough  and  hasty  observer.  A  few  minutes'  careful 
watching  in  these  cases  will  be  productive  of  facts  of 
more  real  diagnostic  help  than  the  most  thorough  and 
painstaking  after  examination. 

During  this  preliminary  inspection  such  details  as  the 
following  may  be  noted :  The  amount  of  injection  of 
the  nasal  mucous  membranes,  the  beat  of  the  heart  as 
counted  by  the  jugular  pulsations,  the  amount  of 
tympany  present,  and  the  number  and  character  of  the 
respirations. 

The  respiratory  movements  are  valuable.  In  extreme 
distension  of  the  abdomen  the  chest  and  diaphragm  carry 
on  the  breathing,  the  action  of  the  abdominal  muscles 
being  suspended.  In  enteritis  and  peritoneal  inflamma- 
tion the  same  thing  occurs.  In  rupture  of  the  diaphragm 
the  respirations  are  often  similar  to  those  of  'broken 
wind,'  and,  owing  to  the  pressure  on  this  muscle,  the 
same  appearance  will  be  met  with  in  extreme  gastric 
distension.  In  all  bad  cases  of  abdominal  disturbance 
the  respiratory  movements  will  be  increased  in  number, 
sometimes  enormously,  and  the  character  of  each  respira- 
tion altered  from  a  noiseless  movement  to  a  gasping  sob. 

All  this    may  be    noticed  in    the  few   minutes'  quiet 


24  THE  COMMON  COLICS  OF  THE  HORSE 

observation  I  have  advised,  and  the  beginner  may  be- 
lieve me  when  I  say  that  the  owner  of  the  animal  is  far 
more  likely  to  be  impressed  with  the  man  who  makes  a 
careful  and  systematic  examination  of  this  nature  than 
with  the  man  of  rapid  diagnosis.  The  latter  he  may 
admire,  the  former  he  will  trust. 

Now  and  again  you  may  meet  with  a  client  who  is 
visibly  struck  with  the  '  lightning  diagnosis  business,' 
and,  whenever  you  see  a  chance,  and  a  safe  one,  of 
exhibiting  this  ability  yourself,  by  all  means  take  advan- 
tage of  it  with  that  particular  cHent.  It  is  not,  how- 
ever, to  be  recommended  as  a  usual  plan  of  procedure. 
Methodical  carefulness  will  tell  the  best  in  the  long-run, 
and  w^ill  lead  you  into  fewer  blunders. 

3.  The  actual  examination  of  the  patient  may 
now  commence. 

The  pulse,  that  grand  tale-bearer  in  these  cases,  should 
be  carefully  noted  both  in  regard  to  the  number  of  beats 
and  its  general  character — constantly  frequent,  or  its 
number  of  beats  only  increasing  with  each  paroxysm 
of  pain,  etc.  ;  wiry  and  thin,  or  full  and  bounding,  etc. 

While  taking  the  pulse,  the  hand  in  the  axilla  should 
note  the  amount  of  perspiration  present,  and  also  ascer- 
tain the  condition  of  the  external  temperature — whether 
the  sweats  are  warm  and  comfortable,  or  chilly  and 
deathlike. 

The  rectal  temperaUive,  though  not  alone  of  diagnostic 
aid,  should  always  be  taken ;  for,  considered  in  conjunc- 
tion with  the  pulse  and  number  of  respirations,  it  will 
sometimes  prove  of  help  in  prognosis — e.g.^  see  the 
chapter  on  Subacute  Obstruction  of  the  Double  Colon. 

4.  The  examination  of  the  abdomen  should  then 
proceed  in  the  following  manner  : 

(i)  By  Palpation. — This  method    of   examination  will 


HOW  TO  EXAMINE  THE  PATIENT  25 

reveal  to  a  very  great  extent  the  amount  of  tension  or 
tympany  present.  In  a  bad  case  of  intestinal  trouble 
the  whole  of  the  abdominal  muscles  will  feel  hard  and 
tense  to  the  touch,  conveying  to  one's  fingers  the  sensa- 
tion of  a  muscle  in  tetanus.  Even  in  the  flanks,  where 
a  certain  amount  of  resilience  is  expected,  the  same  tense 
condition  is  met  with. 

In  some  cases  palpation  exposes  the  existence  of  pain  or 
tenderness,  as,  e.g.,  in  peritonitis  and  enteritis.  In  others 
the  very  reverse  will  be  noticed,  the  pressure  affording  the 
animal  an  appreciable  amount  of  relief.  It  is  wise  to  add, 
however,  that  external  pressure  will  not  always  cause  the 
animal  to  exhibit  signs  that  may  be  absolutely  relied 
upon.  It  is  often  difficult  to  elicit  symptoms  of  pain 
from  our  patients,  but  it  is  still  more  difficult  to  distin- 
guish between  pain  produced  by  pressure  and  ticklish- 
ness,  restlessness,  and  fretfulness,  which  may  simulate 
pain  when  pressure  is  brought  to  bear  upon  any  part, 
particularly  the  abdomen.  Still,  by  palpation  the  surgeon 
will  be  able  to  deduce  a  large  amount  of  information, 
favourable  or  unfavourable  as  the  case  may  be. 

(2)  By  Auscultation. — This  aid  to  diagnosis  should 
never  be  omitted.  The  sounds  occasioned  by  peristalsis 
will  sometimes  be  in  abeyance  or  altogether  wanting,  and 
the  appropriate  remedy  sufficiently  pointed  out.  Or  it 
may  be  that  peristalsis  is  abnormally  in  evidence,  as  in 
the  colic  occasioned  by  the  presence  of  fermenting  foods. 
Both  flanks  should  be  auscultated,  and  also  the  region  of 
the  stomach.  In  the  latter  position  evidence  is  some- 
times obtained  as  to  the  condition — tympanitic  or  other- 
wise— of  that  organ.  If  unduly  full,  regurgitations  will 
often  be  heard  that  are  so  slight  as  to  be  easily  missed  by 
a  mere  observation  of  the  oesophagus  in  the  region  of  the 
neck. 


26  THE  COMMON  COLICS  OF  THE  HORSE 

(3)  By  Rectal  Exploration.  —  No  grandiose  affecta- 
tion of  gvandesse  should  cause  the  surgeon  to  neglect 
this.  Carefully  and  intelligently  performed,  it  is  one 
of  the  grandest  means  at  our  disposal  for  arriving  at 
an  accurate  knowledge  of  the  condition  of  the  bowels. 
The  bladder  and  a  large  portion  of  the  posterior  masses 
of  intestines  are  well  within  reach,  and  the  infor- 
mation gained  by  their  examination  will  be  found  in- 
valuable. 

Notice  should  be  taken  as  to  the  fulness  or  otherwise 
of  the  rectum,  of  the  consistence  of  the  faecal  matter  re- 
moved, whether  semi-fluid  or  hard  and  soHd,  whether 
the  removed  lumps  are  covered  with  mucus  or  not,  and 
whether  of  normal  odour  or  comparatively  stinking  and 
offensive. 

It  should  be  noticed  also  whether  or  not  this  organ  is 
open  ('ballooned')  or  exerting  a  clinging  movement  on 
the  operator's  arm.  In  cases  of  acute  obstruction — 
calculi,  faecal  matter,  and  twist — this  clinging  action  will 
be  particularly  noticeable,  and,  with  it,  the  operator  will 
observe  a  painful  straining  on  the  part  of  his  patient, 
together  with  the  presence  of  tympanitic  or  impacted 
intestines  in  the  pelvis.  In  many  cases  where  this  latter 
has  been  observed  the  obstruction  has  turned  out  to  be 
in  the  single  colon,  and  it  may  be  taken  as  a  general  rule 
that  in  any  case  where  the  pelvis  contains  other  bowels 
than  the  last  portion  of  the  rectum  the  practitioner  has 
a  case  of  a  dangerous  nature  to  deal  with. 

To  the  right  the  operator  should  feel  the  head  of  the 
caecum  and  colon  ;  their  contents  should  not  be  hard,  and 
on  pressure  the  bowel  should  give ;  to  the  left  and 
centre  should  be  felt  the  pelvic  flexure  of  the  colon  with 
its  elastic  contents,  and  to  the  centre  may  be  found  some 
of  the  small  intestines.     They  should  not  be  distended 


HOW  TO  EXAMINE  THE  PATIENT  27 

with  gas.  No  intestine,  large  or  small,  should  exhibit 
pain  or  tenderness  on  pressure. 

(4)  By  Percussion. — This  is  performed  by  tapping  the 
abdominal  walls  with  the  tips  of  the  fingers  of  the  right 
hand,  with  or  without  the  left  hand  interposed.  It  will 
yield  evidence  relating  to  the  contents  and  size  of  the 
viscera.  Percussion  over  an  intestine  filled  with  gas 
gives  a  clear  sound ;  over  one  containing  solid  matter  a 
dull  sound.  Where  the  contents  are  fluid  the  sound  is 
modified. 

This  will  conclude  the  examination  of  the  patient,  and, 
although  taking  time  to  describe,  its  actual  performance 
will  be  found  to  occupy  but  a  very  short  time. 

The  veterinary  fledgling  should  always  follow  some 
such  line  of  systematic  inspection  as  I  have  here  laid 
down.  In  course  of  time  he  will  find  that  it  has  become 
part  of  his  nature,  and  will  be  able  to  rattle  through  it  in 
so  short  a  time  as  to  convey  no  impression  of  painful 
plodding  to  the  outside  observer.  If  possessed  of  tact, 
he  will  manage  to  maintain  a  running  conversation  with 
the  owner  the  while  he  is  doing  it.  He  will  become  fond 
of  his  work,  find  it  both  interesting  and  instructive,  and 
give  all  satisfaction  to  his  client. 


CHAPTER  IV 

ETIOLOGY:  GENERAL  PREDISPOSING 
CAUSES 

Regarding  his  predisposition  to  colic,  the  horse  stands 
apart  from  almost  every  other  animal.  A  brief  considera- 
tion of  such  predisposing  causes  as  are  mentioned  in  this 
chapter  will  be  quite  sufficient  to  make  us  marvel  that 
cases  of  '  colic '  are  not  of  even  more  frequent  occurrence. 
At  any  rate,  it  will  reveal  quite  enough  to  account  for  the 
enormous  preponderance  of  these  cases  in  veterinary 
practice. 

To  commence  with,  there  are  several  physiological  and 
anatomical  conditions,  perfectly  normal  in  themselves, 
which,  nevertheless,  are  entirely  favourable  to  the  pro- 
duction of  these  disorders. 

In  the  first  place,  the  relatively  small  capacity  of  the 
stomach  compared  with  the  animal's  size  must  be  borne 
in  mind,  and,  together  with  this  fact,  the  normal  process 
of  digestion  must  be  remembered.  It  is  evident  to  the 
most  casual  observer  that  the  small  stomach  of  the  horse 
cannot  possibly  contain  the  enormous  amount  of  pro- 
vender that  he  is  able  to  consume  at  one  meal.  As  a 
matter  of  fact,  it  has  been  proved  to  us  that  at  a  certain 
period  of  stomach  digestion  the  amount  of  food  passing 
out  of  the  pylorus  into  the  intestine  equals  the  amount 
entering    the   stomach    by    the    oesophagus.       Notwith- 


GENERAL  PREDISPOSING  CAUSES  29 

standing  this  provision  of  nature  to  avoid  gastric 
impaction,  it  is  easy  to  understand  that  a  quick  or 
greedy  feeder  may  so  bolt  his  food  as  to  bring  about  one 
of  two  conditions  :  either  impaction  of  the  stomach  with 
food  insufficiently  acted  upon  by  the  salivary  fluids,  or 
the  pouring  out  into  the  intestine  of  a  large  amount  of 
improperly  digested  material  from  the  stomach.  The 
mere  fact  of  its  being  imperfectly  digested  in  the  stomach 
leads  to  other  troubles  in  the  intestines.  The  material 
there  is  unable  to  become  properly  assimilated,  and  the 
result  is  either  a  troublesome  diarrhoea  or,  what  is  more 
frequent,  a  condition  of  stasis  or  obstinate  impaction. 

In  addition  to  this,  we  may  carefully  consider  the 
tremendous  volume  of  the  large  intestines,  their  thin  and 
delicate  walls  as  compared  with  the  enormous  amount  of 
bulky  material  they  are  called  upon  to  deal  with,  and, 
finally,  their*  great  length.  This  done,  we  shall  not  be 
much  astonished  at  a  fairly  frequent  occurrence  of  gastric 
and  intestinal  disorders  in  the  horse. 

Again,  notice  what  a  careful  dissection  of  the  stomach 
reveals  (pp.  9  and  17).  It  is  an  anatomical  fact  that  its 
very  build  is  a  distinct  bar  to  the  act  of  vomition.  Con- 
sequently, no  matter  how  sick  the  animal  may  feel,  no 
matter  the  amount  or  irritancy  of  any  deleterious  matter 
he  may  have  swallowed,  there  it  must  remain,  or  travel 
the  whole  length  of  the  sensitive  and  absorbent  surfaces 
of  the  intestines  before  gaining  exit  from  the  body.  The 
anatomical  facts  that  lead  to  that  statement  are  as 
follows  : 

1.  The  small  size  of  the  stomach  and  its  want  of 
contact  with  the  abdominal  walls.  This  is  a  decided 
hindrance  to  its  effectual  compression. 

2.  The  narrowness  of  the  oesophageal  opening ; 
the  thickened  and  contracted  arrangement  of  the  fibres 


30  THE  COMMON  COLICS  OF  THE  HORSE 

of  the  cardiac  extremity  of  the  oesophagus ;  the  oblique 
manner  in  which  the  latter  enters  the  gastric  walls ;  the 
peculiar  arrangement  of  the  folds  of  mucous  membrane 
lining  its  interior  ;  and  the  presence  of  the  cardiac 
sphincter,  already  described  on  pp.  9  and  20 — these  are 
all  factors  in  bringing  about  complete  occlusion  of  the 
oesophageal  opening. 

.3.  The  pyloric  outlet — comparatively  distended — 
lying  close  to  and  below  the  sealed  oesophageal  inlet. 
That  being  so,  it  naturally  follows  that  any  compression  of 
the  gastric  walls  forces  the  stomach  contents  with  equal 
strength  towards  both  the  oesophageal  and  duodenal 
openings.  The  contained  material  finds  the  readiest 
road  of  exit — the  pylorus.  The  offending  material,  which 
may  have  given  rise  to  inclination  to  vomit,  is  passed  by 
adverse  force  of  circumstance  into  the  intestine. 

Proceeding  with  the  intestines  themselves,  we  note 
first  of  all  the  formation  of  the  so-called  '  duodenal  trap,' 
as  illustrated  on  pages  10  and  11.  In  cases  of  distended 
stomach  or  intestines  this  S-shaped  piece  of  intestine  is 
compressed  and  its  contents  rendered  stationary.  This 
is  undoubtedly  another  great  factor  in  the  production  of 
gastric  and  intestinal  obstructions,  with  their  attendant 
colicky  pains.  Following  this,  we  observe  the  differences 
in  the  size  of  the  various  parts  of  the  colon,  together  with 
its  several  flexures,  and  note  also  the  length  and  com- 
paratively free  location  of  this  organ  and  the  caecum. 
Taken  collectively,  these  circumstances,  though  quite 
normal  in  themselves,  must  still  be  held  to  be  favourable 
to  the  production  of  colic. 

Again,  I  think  every  practitioner  will  bear  me  out 
when  I  say  that  age  is  frequently  a  predisposing  cause  of 
these  complaints.  With  advancing  age  there  is  not  the 
amount  of  what  is  commonly  called  '  tone  '  in  the  system. 


GENERAL  PREDISPOSING  CAUSES  31 

The  teeth  do  not  perfectly  perform  their  proper  function, 
and  the  food  is  passed  on  in  a  half-masticated  state,  and 
without  the  requisite  admixture  of  salivary  fluid.  The 
digestion  is  far  from  being  so  quick,  and  a  large  amount 
of  bulky  food  is  less  easily  disposed  of.  The  circulation, 
too,  is  not  so  free,  in  consequence  of  which  there  is  less 
gastric  juice  secreted — often  not  sufficient — and  impaction 
is  the  result. 

Here,  also,  attention  may  be  given  to  the  time  occupied 
in  the  passage  of  food  through  the  digestive  canal  of  the 
horse. 

Henry  Jarvis,  in  1872,  in  four  experiments,  observed 
the  following : 

Horse  No.  i,  fed  on  oats,  performed  half  an  hour's 
exercise,  and  passed  oats  in  twenty-four  hours. 

Horse  No.  2,  fed  on  oats,  performed  a  nine  miles' 
journey,  and  passed  oats  in  twenty-two  hours. 

Horse  No.  3,  fed  on  oats,  kept  quiet  in  stable,  and 
passed  oats  in  twenty-seven  hours. 

Horse  No.  4,  fed  on  oats,  kept  quiet  in  stable,  and 
passed  oats  in  twenty-seven  and  a  half  hours. 

These  periods,  I  need  hardly  add,  are  comparatively 
short,  and  the  average  time  has  been  estimated  by  other 
authors  to  be  nearly  four  days.  In  either  case  the  time 
is  wonderfully  short.  This  fact  must  be  remembered  in 
close  connection  with  another  :  I  refer  to  the  nature  of  the 
horse's  food.  We  know  quite  well  that  a  very  great  pro- 
portion of  his  provender  is  of  an  indigestible  nature,  and 
that  a  very  large  amount  of  the  material  taken  into  his 
body  is  excreted  unchanged.  We  know  equally  well  that 
this  excretion  is  going  on  with  almost  mathematical 
regularity  throughout  the  day.  In  other  words,  the 
horse  in  health  requires  to  empty  his  rectum  eight  to 
ten  or  twelve  times  during  every  twenty-four  hours. 


32  THE  COMMON  COLICS  OF  THE  HORSE 

It  requires  but  a  few  moments'  consideration  to  dis- 
cover what  a  great  bearing  this  has  upon  the  frequency 
of  his  attacks  of  colic.  I  have  repeatedly  seen  cases 
where,  without  actual  or  complete  stasis,  the  horse's 
bowels  have  performed  only  one  evacuation  daily.  In 
every  case  so  observed  dull  colic  pains  have  supervened 
before  the  expiration  of  twenty-four  hours. 

Compare  this  with  the  human  subject  in  health.  The 
average  man  is  able  to  comfortably  rid  himself  of  his 
twenty-four  hours'  excreta  by  the  passage  of  one  stool 
daily.  This  means  that  the  horse's  bowels  perform  in 
one  day  what  those  of  a  man  perform  in  seven  or  eight, 
and  that  cessation  of  the  act  of  defaecation  for  twenty- 
four  hours  in  the  horse  is  practically  equivalent  to  a 
cessation  of  seven  days  in  man.  That  is  putting  it  at  its 
lowest  computation. 

In  view  of  that,  it  is  easily  understood  why  it  is  that 
pain  follows  so  rapidly  on  apparently  slight  stasis  of  the 
bowels  in  the  horse.  We  may  now  see  how  it  is  that 
cessation  of  the  normal  act  of  defaecation  for  twelve 
hours,  or  even  less,  is  quite  sufficient  to  bring  on  symp- 
toms of  pain,  except  under  extraordinary  circumstances. 
It  is  this  that  renders  equine  colics  of  such  serious 
importance  to  the  veterinarian.  It  explains  in  great 
measure  the  rapid  and  oftentimes  fatal  course  they  run, 
and  impressively  points  out  the  urgent  necessity  for 
prompt  and  precise  remedial  measures.  This,  more  than 
anything  else,  should  induce  the  veterinary  surgeon  to 
carefully  weigh  his  data  before  jumping  at  a  diagnosis. 
Above  all,  it  should  cause  him  to  deliberately  ponder,  and 
perhaps  stay  his  hand,  before  administering  those  agents  which 
tend  to  kill  pain,  but  at  the  same  time  tightly  lock  the  bowels. 
He  may  exhibit  opiates  or  sedatives  with  the  most 
humane   of  all    objects — that    of  alleviating   agonizing 


GENERAL  PREDISPOSING  CAUSES  y^, 

suffering  in  a  dumb  animal — but  he  should  never  forget 
that  his  first  duty  is  to  preserve  life.  I  have  remarked 
thus  fully  upon  this  in  order  that  I  might  point  out  as 
conclusively  as  possible  this  fact.  Of  all  the  predisposing 
causes  to  attacks  of  colic,  this  regular  frequency  with 
which  the  horse  evacuates  the  contents  of  his  bowels  is 
to  be  looked  upon  as  of  supreme  importance. 

Hereditary  Predisposition. — '  Are  diseases  of  the 
bowels  hereditary  ?  Why  not  ?  Cannot  an  amount  of 
susceptibility  be  transmitted  from  parent  to  progeny  ? 
May  there  not  be  a  diathesis  transmitted,  by  which  the 
structure  of  the  bowels  is  more  susceptible  to  disease  in 
some  than  in  others  ?  If  cases  were  carefully  traced 
back,  might  we  not  find  that  the  sire  or  the  dam  had 
been  subject  to  some  disease  of  the  bowels  ?' 

These  are  questions  asked  by  a  practitioner  in  the 
Veterinary  Journal.  To  all  of  them  I  can  confidently 
answer  in  the  affirmative.  I  have  frequently  been  told, 
when  attending  a  case,  that  the  animal's  mother  was 
always  subject  to  colic.  '  Ay,  and  her  mother  died  from 
it,  too  !'  is  often  the  close  of  the  owner's  remarks.  Seeing 
that  as  many  as  50  to  90  per  cent,  of  the  total  cases  in 
some  practices  are  those  of  colic,  it  is  no  great  argu- 
ment, I  admit,  to  say  that  because  one  patient's  mother 
died  from  colic  the  offspring  of  other  victims  of  the 
disorder  must  necessarily  inherit  a  fatal  predisposition. 
Nevertheless,  the  point  that  has  struck  me  is  the 
frequency  with  which  one  hears  the  word  *  always ' 
inserted. 

With  a  certain  amount  of  hesitancy,  I  also  put  down 
*  weather  '  as  a  predisposing  cause  of  these  complaints. 
We  all  know  the  way  in  which  the  weather  exerts  an 
effect — baneful  or  beneficial — upon  ourselves.  It  is  only 
fair  to  add  that  these  same  influences  are  at  work  among 

3 


34  THE  COMMON  COLICS  OF  THE  HORSE 

the  lower  animals.  In  short,  every  practitioner  mus;l 
have  noticed  the  prolific  crop  of  colic  that  speedily 
follows  a  spell  of  cold,  showery  weather,  when  previously 
all  has  been  warm  and  dry. 

Temperament  as  a  Predisposing  Factor.— This 
should  really  come  under  the  heading  of  heredity.  All  I 
need  add  to  what  I  have  already  said  in  that  paragraph 
is  that  I  have  frequently  noticed  that  animals  of  a 
sluggish,  lymphatic  nature  are  more  liable  to  repeated 
attacks  of  colic  than  are  others. 

Last,  but  by  no  means  least,  in  this  lengthy  category 
of  predisposing  causes  comes  a  reference  to  the  mucous 
membrane  of  the  intestines.  I  think  no  one  will  deny 
that  the  delicate  lining  of  the  bowels  in  the  horse  is 
much  more  sensitive  to  deleterious  matters  than  that 
of  any  other  domestic  animal.  In  proof  of  which, 
witness  the  agonizing  pains  that  accompany  the  least 
disturbance  of  his  alimentary  tract,  and  the  rapidity  with 
which  the  animal  succumbs.  Witness,  also,  the  rapid 
and  fatal  effects  of  comparatively  small  doses  of  irritant 
poisons :  the  animal's  dejected  and  downcast  demeanour, 
and  his  absolute  indifference  to  everything  except  the 
torturing  pain  which  is  rendering  his  case  hopeless  and 
pitiable  in  the  extreme. 

This  chapter,  then,  details  some,  though  not  all,  of 
those  causes  that  tend  to  the  production  of  equine  colic. 
The  practitioner  need  not,  however,  be  dismayed  by  their 
apparent  infinity.  Although,  for  anatomical  and  physio- 
logical reasons,  the  horse  is  fearfully  liable  to  paroxysms 
of  these  agonizing  pains,  the  veterinarian  should  en- 
deavour to  remember  that  many  of  these  predisposing 
causes  are  often  energetically  helped  into  being  active 
ones  by  the  crass  stupidity  of  the  animal's  attendant. 


CHAPTER  V 

ETIOLOGY:    GENERAL    EXCITING 
CAUSES 

In  this  chapter  I  intend  to  briefly  enumerate  such 
exciting  causes  of  colic  as  will  render  repetition  un- 
necessary in  future  pages.  As  far  as  possible  I  shall 
describe  those  circumstances  and  influences  that  are 
commonly  at  work  in  the  production  of  these  disorders. 
It  will  save  me  the  trouble,  and  my  readers  the  annoy- 
ance, of  repeating  several  times  the  same  matter  under 
different  headings. 

It  matters  but  little  in  what  district  the  practitioner  of 
veterinary  medicine  may  pitch  his  tent,  he  will  be  certain 
to  find  that  far  and  away  the  most  common  cause  of  the 
equine  colics  is  the  one  that  may  be  best  described  by 
the  single  word  '  domestication.'  The  horse,  probably 
more  than  any  other  animal,  is  under  man's  control  and 
at  man's  disposal.  So  long  as  he  is  allowed  to  roam  the 
fields,  gathering  his  food  in  a  rough  and  scanty  manner, 
taking  his  exercise  as  he  himself  sees  fit,  and  resting 
when  nature  dictates,  so  long  will  he  remain  a  picture  of 
perfect  health.  Man  steps  in,  and  the  colt's  life  of 
freedom  is  at  an  end. 

The  nature  of  his  food,  its  quality  and  quantity,  and 
the  frequency  with  which  he  may  be  allowed  to  partake 


36  THE  COMMON  COLICS  OF  THE  HORSE 

of  it — all  these  circumstances  are  entirely  under  man's 
control,  often  caprice.  His  manner  of  living  may  vary 
from  several  days  per  week  of  a  constrained  idleness  in 
the  stable — with  its  attendant  evils  of  sluggish  liver, 
swelled  legs,  uncalled-for  corn,  and  unnecessary  fat — to 
an  enforced  life  of  yearly  labour  far  beyond  his  endurance, 
with  a  lack  of  proper  maintenance,  and  a  disgraceful 
neglect  of  his  comfort  when  ailing.  The  ill  effects  of 
domesticating  the  horse,  so  far  as  they  tend  to  the 
production  of  colic,  I  purpose  describing  under  separate 
heads  as  follows : 

{a)  Food. — There  are  several  reasons  that  lead  one 
to  look  upon  the  food  as  a  prominent  factor  in  the 
causation  of  colic.  In  the  majority  of  cases,  unless  the 
horse  be  one  of  a  large  stud,  where  the  business  of 
feeding  is  reduced  almost  to  an  exact  science,  this  food 
is  selected  without  any  regard  for  the  proper  balance 
of  its  constituents  as  a  suitable,  easily  digested,  and 
economical  diet.  Even  in  cases  where  some  little  atten- 
tion is  paid  to  this  essential  by  the  owner,  his  well-meant 
intentions  fail  in  that  the  animal's  attendant  will  use  far 
too  much  of  the  food  so  chosen,  or,  in  others,  the  niggard- 
liness of  the  owner  prevents  the  requisite  amount  being 
given. 

In  my  own  district  it  is  absolutely  impossible  to  arrive 
at  any  just  measure  of  the  amount  weighed  out  per  diem 
to  each  horse.  The  owner  will  tell  you  one  thing,  the 
men  another,  and  the  horse,  by  his  illness,  contradict 
both.  Oats,  the  food  par  excellence  for  the  horse,  is  very 
seldom  used  even  in  country  districts.  It  is  sent  in  bulk 
to  market,  and  maize  purchased  in  its  stead.  In  agricul- 
tural districts  the  maize  has  added  to  it  whatever  else 
may  by  chance  be  on  the  farm.  More  often  than  not 
this  is  wheat  or  barley — two  notoriously  bad  foods  for 


GENERAL  EXCITING  CAUSES  37 

horses.  If  these  be  not  available,  then  bran  is  the  next 
obtained.  Bran  mixed  with  maize  forms  much  too 
laxative  a  diet  for  the  horse  in  work  ;  it  is  certainly  not 
economical,  and  is,  moreover,  a  frequent  cause  of  an 
attack  of  colic. 

Nor  must  we  forget  the  enormous  quantities  of  foreign 
feeding  materials  that  are  poured  into  our  markets  in 
these  days  of  rapid  trans-oceanic  transit.  It  is  principally 
the  equine  dwellers  in  our  large  towns  that  are  likely  to 
suffer  from  their  introduction,  and  we  have  had  startling 
evidence  of  the  ill  effects  of  these  materials  in  out- 
breaks of  such  serious  importance  as  '  poisoning  by 
muttars'  and  the  conveyance  of  anthrax.  Putting 
diseases  of  that  nature  on  one  side,  it  is  a  well-known 
fact  that  cargoes  of  such  materials  are  notoriously  full  of 
dust  and  other  foreign  substances — e.g.,  scraps  of  iron, 
sand,  stones,  etc. 

In  some  districts  it  is  a  common  practice  to  feed  the 
animals  once  weekly  with  food  that  has  been  boiled,  or, 
when  making  them  up  for  sale,  to  diet  them  largely  on 
it  for  several  weeks  prior  to  selling.  Though  probably 
more  easy  of  digestion,  I  fear  such  food  is  often  ravenously 
bolted,  and  in  that  way  lays  the  foundation  for  colic. 

The  several  questions  bearing  on  the  matter  of  food, 
its  economic  value,  mode  of  administration,  etc.,  are 
various  and  widely  differing.  In  the  hope  of  rendering 
this  little  volume  of  direct  practical  value  to  the  prac- 
titioner of  veterinary  medicine  and  to  the  stock-owner,  I 
have  added  an  appendix  entering  more  into  detail  on  this 
matter  ;  there  is,  therefore,  no  need  for  me  to  enlarge 
upon  it  here. 

(b)  Water. — Personally,  I  am  not  of  the  opinion  that 
this  can  often  be  looked  upon  as  the  direct  cause  of  colic. 
Unless   it   is  sufficiently  impregnated  with  the  salts   of 


38  THE  COMMON  COLICS  OF  THE  HORSE 

calcium  to  lead  to  the  formation  of  calculi,  which  by 
their  presence  act  mechanically  as  obstructive  agents, 
I  do  not  think  we  need  often  consider  the  water-supply 
when  treating  a  case  of  colic.  There  is  one  exception 
of  importance :  cases  where  the  water  is  likely  to  be 
contaminated  by  passing  through  new  leaden  pipes,  or 
stored  in  leaden  cisterns,  or  in  tanks  whose  joints  have 
been  cemented  with  a  putty  composed  largely  of  lead 
carbonate. 

Since  these  statements  forbid  us  to  regard  the  water 
itself  as  a  cause  of  colic,  we  are  compelled  to  look  deeper 
into  the  matter.  We  must  endeavour  to  trace  its  ill  effects, 
if  any,  to  the  manner  or  time  of  its  administration. 

Firstly,  there  is  but  one  mode  of  allowing  it  that  need 
be  considered  at  all  seriously.  Should  the  water  be 
given  excessively  cold  to  an  animal  greatly  heated  with 
exercise?  As  there  is  nothing  definitely  proved  upon 
this  point,  it  remains  largely  a  matter  of  common-sense 
reasoning  based  upon  experience.  It  must  be  remem- 
bered  that  an  animal  just  returned  from  violent  exertion 
has  had  his  system  greatly  depleted  of  fluid.  That  this 
fluid  needs  replacing  is  beyond  question.  Personally,  I 
am  led  to  believe  that  while  the  animal  is  still  warm  is 
the  best  time  to  allow  him  to  have  it.  The  way  I  reason 
it  is  this  :  Prolonged  muscular  exertion  has  robbed  the 
body  of  a  large  amount  of  combustible  material ;  this 
certainly  requires  to  be  given  back  again  in  the  form  of 
food.  The  animal  will  not  eat  sufficiently  until  his  thirst 
has  been  satisfied,  therefore  the  water  should  come  first. 
Why  not  allow  him  to  cool  first,  then  water  and  after- 
wards feed  him  ?  That  question  may  be  answered  thus : 
After  violent  exercise  the  body  temperature  rapidly  sub- 
sides— at  any  rate,  the  feeling  of  warmth  does ;  in  other 
words,  there  is  a  corresponding  reaction.     If  after  this 


GENERAL  EXCITING  CAUSES  39 

reaction  has  set  in — i.e.,  when  the  animal  begins  to  feel 
chilly — he  is  allowed  to  drink  freely  of  cold  water,  his 
system  is  sure  to  feel  its  effects  with  double  intensity, 
and  a  condition  of  the  body  will  be  induced  decidedly 
unfavourable  to  the  proper  digestion  of  the  feed  to  follow. 
The  temperature  and  high  degree  of  functional  activity 
occasioned  by  the  exercise  should  be  utilized  to  raise  the 
temperature  of  the  requisite  amount  of  water  the  system 
requires  before  reaction  has  commenced ;  the  animal  is 
then  enabled  to  take  in  the  necessary  fuel  for  further 
combustion.  These  remarks  do  not  apply  to  an  animal 
that  has  returned  to  his  stable  in  a  state  of  great 
exhaustion  or  fatigue.  In  my  own  stables  the  above  has 
been  the  custom  for  a  great  number  of  years.  Never 
once  have  I  been  able  to  attribute  to  it  any  ill  effects. 
It  must  not  be  forgotten,  however,  that  custom  in 
watering  animals  should  never  be  quickly  changed. 
Anyone  who  has  accustomed  his  steed  to  a  different 
procedure  from  that  mentioned  should  not  suddenly 
alter  it. 

Secondly,  we  come  to  the  time  of  its  administration. 
Should  horses  be  watered  before,  between,  or  after  feed- 
ing ?  This  again  opens  up  a  question  regarding  which 
nothing  is  clearly  settled.  In  an  attempt  to  determine  it, 
Professor  F.  Tangl,  of  the  Veterinary  College,  Budapest, 
offers  some  interesting  experiments  and  conclusions.^ 
Without  detailing  his  experiments,  which  would  encroach 
too  far  on  my  space,  it  will  suffice  to  give  this  gentle- 
man's summary.     He  says  : 

'  Horses  may  be  watered  before,  during,  or  after  meals 
without  interfering  with  the  digestion  and  absorption  of 
the  food.     All  these  methods  of  watering  are   equally 

^  Journal    of   Comparative    Pathology    and    Therapeutics,    vol.   xv., 

p.  21. 


40  THE  COMMON  COLICS  OF  THE  HORSE 

good,  and  each  of  them  may  be  employed  according  to 
circumstances.  It  is  obvious  that  certain  circumstances 
may  make  it  necessary  to  adopt  one  or  other  method. 
I  need  only  mention  as  an  example  that,  after  severe 
loss  of  water,  such  as  occurs  in  consequence  of  long- 
continued  exertion,  the  animal  should  always  be  allowed 
to  drink  before  it  is  fed,  as  otherwise  it  will  not  feed 
well.  Although  all  methods  of  watering  are  equally 
good  for  the  horse,  it  is  not  desirable  to  change  un- 
necessarily from  one  method  to  another.  Animals,  or 
at  least  some  of  them,  appear  to  be  not  altogether  in- 
different to  such  a  change.  We  observed  in  our  experi 
ments  that  whenever  a  change  was  made  from  the  plan 
of  watering  after  food  to  that  of  watering  before,  the 
appetite  fell  off  for  some  days ;  not  that  they  did  not 
consume  the  whole  of  the  food  given  to  them,  but  for 
some  days  together  they  did  not  eat  with  the  same 
avidity,  and  took  a  longer  time  to  consume  their  rations 
completely.  A  similar  effect  was  not  observed  when  the 
change  was  from  watering  before  to  watering  after  food, 
or  from  watering  after  to  watering  during  meals,  or  when 
the  change  was  in  the  opposite  direction  to  the  last. 
It  is  possible  that  this  method  of  watering  before  food, 
until  the  animal  has  become  accustomed  to  it,  produces 
a  certain  feeling  of  satiation.  Further  experiments  would 
be  necessary  to  show  to  what  extent,  apart  from  the  bad 
effects  of  an  excessive  consumption  of  water,  the  plan  of 
watering  after  meals  acts  injuriously  on  digestion  in  the 
case  of  foods  that  are  difficult  of  digestion  or  tend  to 
induce  tympany,  such  as  grains  provided  with  an 
envelope.' 

(c)  Errors  in  the  Proper  Distribution  of  Work, 
Rest,  Watering-,  and  Feeding.— Of  all  the  baneful 
effects  of  domesticating  the  horse  that  tend  to  the  pro- 


GENERAL  EXCITING  CAUSES  41 

duction  of  colic,  by  far  the  greater  part  will  be  found 
under  this  heading. 

The  small  stomach  of  the  horse  offers  a  fair  reason  to 
suppose  that  it  should  be  often  filled  during  the  day,  in 
order  that  the  amount  of  ingesta  required  by  his  volumin- 
ous intestines  may  be  adequately  provided.  Observation 
of  the  horse's  natural  habits  sufficiently  points  this  out, 
and  yet  how  often  we  see  this  teaching  of  nature  grossly 
ignored.  Percivall,  with  his  usual  terseness  of  argu- 
ment, suggests  that  when  the  natural  habits  are  changed 
for  new  ones,  by  confirmation  of  time  and  usage  these 
come  to  appropriately  take  the  place  of  those  ordinarily 
natural.  He  is  evidently  referring  to  the  '  three  meals  a 
day  '  system  of  feeding  the  horse,  which  custom  has  come 
to  substitute  for  the  animal's  constant  grazing  when  at 
large  and  at  pasture.  Probably,  if  man  were  content  to 
allow  even  these  necessary  three  meals,  and  at  regularly 
fixed  hours,  cases  of  colic  would  be  far  less  numerous. 
Such,  however,  is  not  the  case.  Percivall  himself  goes 
on  to  remark  :  '  How  often  do  we  see  horses,  hunters 
especially,  taken  to  work  at  eight  or  nine  o'clock  in  the 
morning,  and  not  returned  to  their  stables  before  five,  six, 
or  seven  o'clock  at  night.'  He  then  proceeds  to  point 
out  that  the  well-bred  horse  will  endure  this  long  fasting, 
and  subsequent  repletion,  with  comparative  impunity; 
that  coarse-hred  ones  and  cart-Jiorses  will  not,  but  suffer,  as  a 
result,  from  stomach  troubles.'^  As  an  example  of  the  way 
in  which  the  animal's  constitution  is  sometimes  abused  in 
this  respect,  I  cannot  do  better  than  quote  from  a  former 
article  of  mine  referring  to  the  feeding  of  horses  in  my 
own  district  i^ 

'  Whether  the   horse   be  in  hard,  every-day  work,  or 

1  The  italics  are  mine. — H.  C.  R, 

"•  Journal  of  Comparative  Pathology  and  Thcrapcntics,  vol.  xiii.,  p.  27. 


42  THE  COMMON  COLICS  OF  THE  HORSE 

out  of  harness  altogether,  he  has  at  the  customary  hours 
the  same  quantity  of  food  thrown  into  his  manger. 
These  hours,  by-the-by,  are  only  twice  daily — one  large, 
long  feed  at  daybreak,  and  another  large  feed  towards 
evening.  Then,  again,  in  Lincolnshire,  the  district  I  am 
speaking  of,  there  is  often  one  long  spell  of  work  from 
seven  o'clock  in  the  morning  until  three  in  the  afternoon, 
during  which  time  no  break  is  made  to  refresh  the 
animals ;  no  water  to  drink ;  no  nose-bag  to  their  faces. 
A  break  they  certainly  get  at  eleven  o'clock,  when  they 
stand  in  a  profuse  perspiration,  still  harnessed  to  the 
harrow  or  the  plough  in  the  middle  of  a  field,  their  heads 
down,  and  a  biting,  cutting,  cold  east  wind,  from  which 
in  the  Fens  there  is  not  a  particle  of  shelter,  blowing 
about  them,  while  the  man  in  charge,  under  the  lee  of 
a  close-cut  hedge,  sits  stolidly  munching  his  lunch. 
Again,  without  bite  or  sup,  the  horses  resume  their  work 
and  remain  at  it  until  three.  Then,  in  a  state  of  exhaus- 
tion and  fatigue,  when  the  powers  of  the  digestive  tract 
are  probably  at  their  lowest,  the  animal  is  placed  in  front 
of  an  enormous  feed  of  indigestible,  bulky  food.  After 
filling  his  stomach,  he  is  allowed  to  drink  heartily  of  the 
water  he  has  perhaps  been  craving  for  all  day.  Every 
practitioner  in  this  district  must  well  know  the  Monday 
evening  crop  of  colic.  Sunday's  rest,  Sunday's  gorging, 
and  Monday's  day  of  ceaseless  work  and  fasting,  all 
combine  to  produce  the  colic  of  Monday  evening. 

'This  is  the  state  of  things  existing  in  the  winter 
months,  with,  perhaps,  the  break  in  field  operations 
occasioned  by  a  spell  of  frost,  which  again  only  means 
another  period  of  gorging  in  the  stables.  In  the  summer 
months  the  animals  live  the  greater  part  of  the  time 
in  the  open,  and  the  veterinary  surgeon's  sphere  of  use- 
fulness, for  a  time,  is  limited,  with  one  exception.     It  is 


GENERAL  EXCITING  CAUSES  43 

no  uncommon  thing  for  a  farmer  to  take  his  nag  straight 
away  from  pasture,  give  him  a  feed  of  corn,  and  drive 
him,  full  of  grass,  long-coated,  ungroomed,  and  per- 
spiring, six,  eight,  or  ten  miles  to  the  nearest  market 
town.  Here  he  is  allowed  to  stand  huddled  up  with 
several  of  his  fellows  in  a  dirty  and  badly-ventilated 
stable,  from  eight,  nine,  or  ten  o'clock  in  the  morning, 
until  three,  four,  or  five  in  the  afternoon,  during  which 
time  he  has  not  eaten  or  drunk  a  mouthful.  He  is  then 
geared  to  the  cart  again,  and  does  the  return  journey. 
His  reward  for  that,  on  reaching  home,  is  an  extra  large 
feed  of  corn,  given  at  a  time  when  I  unhesitatingly  say 
he  should  have  less  ;  after  which  he  is  again  turned  out 
into  the  field  for  the  night,  to  stand,  perchance,  the  whole 
of  the  time  in  a  pouring  rain.' 

Referring  again  to  Percivall's  observed  immunity  of 
the  hunter,  it  must  not  be  forgotten  that  this  animal, 
as  compared  with  the  cart-horse,  has  the  advantage  of 
the  excitement  of  the  chase.  For  him  it  has  not  been  a 
day  of  ceaseless,  unvaried  toil.  Every  huntsman  knows 
full  well  that  the  steed,  as  much  as  the  rider,  partakes  of 
the  exhilarating  influences  engendered  by  the  sport.  In 
other  words,  it  is  the  matter  of  temperament,  already 
referred  to  in  Chapter  IV. 

The  Influence  of  the  Time  of  Day  on  the 
Production  of  Colic.  —  As  far  as  I  remember, 
General  F.  Smith  was  the  first  to  point  out  the 
enormous  number  of  colic  cases  that  occurred  after  the 
hour  of  2.30  p.m.,  as  compared  with  those  occurring 
earlier  in  the  day.  Following  his  example,  I  have 
tabulated  my  cases,  and  the  table  on  p.  44  will 
show  that  the  majority  of  cases  in  this  district  are 
attacked  between  the  hours  of  12  noon  and  7  p.m. 
inclusive. 


44 


THE  COMMON  COLICS  OF  THE  HORSE 


Hour. 

Cases. 

Hour. 

Cases. 

//ozr;'.           Cflfs^s 

4  a.m. 

0 

12  noon 

3 

8  p.m.              0 

5     .. 

I 

I  p.m. 

0 

9     ..                 0 

6 

2 

2     ,, 

0 

10     ,,                 0 

7 

I 

3     .. 

2 

II     ,,                 0 

8 

0 

4     .. 

3 

12  midnight      0 

9 

0 

5     .. 

0 

I  a.m.              0 

10 

0 

6     ,, 

2 

2     .,                 0 

II 

2 

7     .. 

2 

3     ..                 0 

In  this  district  I  account  for  the  preponderance  of 
cases  after  noon  by  attributing  it  to  the  long  stretch  of 
work  without  food,  and  the  ravenous  feeding  on  bulky, 
indigestible  material  immediately  afterwards.  I  have  also 
noticed  that  the  great  bulk  of  the  cases  occurring  in  the 
early  morning — say  from  4  or  5  a.m.  until  noon — are 
those  that  turn  out  to  be  fatal. 

Other  and  Various  Exciting  Causes  of  Colic 
— Ingestion  of  food  contaminated  with  sand  or  gravelly 
material,  or  containing  substances  (scraps  of  iron,  wire 
nails,  etc.)  likely  to  form  nuclei  of  calculi.  Catarrh 
of  the  intestines  often  accompanies  influenza  and  many 
respiratory  affections,  and  animals  convalescent  from 
these  maladies  have  a  weakened  digestive  tube,  and  are 
prone  to  constipation  and  impaction.  Aneurism  of  the 
anterior  mesenteric  artery,  due  to  the  presence  of 
strongyles,  frequently  determines  the  impaction  of  faeces, 
owing  to  the  interference  with  the  blood-supply  to  the 
caecum  and  colon.  Pieces  of  the  thrombus  break  off, 
and  effectually  plug  smaller  arteries  supplying,  mainly, 
parts  of  the  caecum  and  colon.  In  the  anaemic  area  of 
bowel  thus  produced  peristalsis  is  diminished,  or  perhaps 
altogether  in  abeyance.  As  a  consequence  we  get  great 
weakness,  or  even  paralysis,  of  that  portion  of  the 
bowel,  with  a  tendency  to  stasis  of  its  contents,  and 
obstruction  from  faecal  accumulations.  Other  factors 
that,  directly  or  indirectly,  tend  to  produce  constipation 


GENERAL  EXCITING  CAUSES  45 

and  faecal  obstructions  are :  large  quantities  of  omental 
fat,  pressure  of  tumours,  and  repeated  pregnancies,  dis- 
tending and  weakening  the  abdominal  parietes.  For  my 
own  part,  I  am  quite  satisfied  that  the  mere  presence  of 
the  foetus,  in  the  later  stages  of  gestation,  is  mechani- 
cally accountable  for  many  of  our  cases  of  colic,  par- 
ticularly obstructive.  Occupying,  as  it  does,  a  large 
proportion  of  the  abdominal  cavity,  it  must  interfere 
considerably  with  the  actions  and  movements  of  the 
intestines  ;  that  is  leaving  out  of  the  question  entirely 
the  fact  that  a  large  portion  of  the  blood-current  of  the 
mother  is  necessary  for  its  development. 

In  these  days,  too,  the  rapid  strides  of  bacteriology 
must  not  be  forgotten.  I  should  not  be  surprised  at  any 
moment  to  pick  up  one  or  other  of  our  veterinary  journals 
and  read  that  some  eminent  scientist  had  discovered  a 
specific  germ  for  such  of  our  cases  of  colic  as  run 
the  rapid  and  fatal  course  of  from  twelve  to  twenty-four 
hours  only.  One  would  imagine  that  in  cases  of  twist, 
for  example,  the  pain,  however  agonizing,  would  not  of 
itself  be  sufficient  to  kill  the  patient.  To  my  mind  there 
is  only  one  solution  that  fairly  fits  the  case — bacterial 
infection  of  the  blood-stream  commencing  from  the 
intestines.  More  especially  do  these  remarks  apply  to 
what  is  known  among  veterinarians  as  '  enteritis.'  That, 
however,  I  will  deal  with  in  the  chapter  reserved  for  its 
discussion. 

In  this  chapter  I  think  I  have  now  indicated  sufficient 
to  direct  the  veterinarian's  attention  to  the  errors  he 
sees  daily  perpetrated  around  him.  Customs  vary  in 
different  counties,  and  it  is  sometimes  only  necessary  to 
step  across  an  imaginary  boundary  to  see  manners  and 
usages  totally  unlike  those  to  which  one  has  been  accus- 
tomed.    It  is,  therefore,  quite  impossible  that  I  can  dis- 


46  THE  COMMON  COLICS  OF  THE  HORSE 

cuss  them  all.  It  remains  for  the  practitioner  to  take 
the  initiative  in  his  own  district,  and  to  fight  strenuously 
and  continuously  against  customs  and  usages  which  his 
better  education  and  wider  experience  show  him  to  be 
wrong. 


CHAPTER  VI 

GASTRIC  IMPACTION 

(GORGED    STOMACH,    GRASS    STAGGERS, 

OR  STOMACH  STAGGERS) 

Definition. — Under  this  heading  I  purpose  describing 
a  disorder  which  is  famiharly  known  to  veterinarians  as 
'  stomach  staggers  ';  and  throughout  this  chapter  I  wish 
to  indicate  that  I  am  referring  to  that  state  of  the  stomach 
in  which  it  is  overfilled  or  gorged  with  food.  No 
tympany.  In  other  words,  it  is  a  condition  of  affairs  in 
the  stomach  comparable  to,  and  agreeing  in  every  way 
with,  that  state  of  the  intestines  known  as  •'  subacute 
obstruction,'  or  '  impaction.' 

Williams,  in  his  '  Principles  and  Practice  of  Veterinary 
Medicine,'  looks  upon  this  disorder  as  merely  a  symptom 
attending  inflammation  of  the  brain  and  its  meninges, 
and  concludes  his  paragraph  on  its  definition  in  these 
words  :  '  The  most  common  form  of  congestion  of  the 
brain  and  its  membranes,  both  in  the  horse  and  horned 
cattle,  is  that  called  stomach  staggers,  or  grass  staggers, 
a  disease  which  sometimes  rages  as  an  enzootic' 

I  cannot  say  that  I  agree  with  him.  Rather  I  prefer 
to  turn  to  an  older  writer  (Percivall),  and  quote  again  :  'A 
stomach  surcharged  with  food,  without  any  accompany- 
ing tympanic  distension,  does  not  appear  to  occasion  any 


4S  THE  COMMON  COLICS  OF  THE  HORSE 

local  pain,  but  operates  that  kind  of  influence  upon  the 
brain  which  gives  rise  to  symptoms,  not  stomachic,  but 
cerebral ;  hence  the  analogy  between  this  disease  and 
"  staggers,"  and  hence  the  appellation  for  it  of  "  stomach 
staggers."  ' 

It  may  be  that  the  total  absence  of  colicky  pains  has 
led  to  the  actual  seat  of  mischief  being  overlooked, 
and  the  symptoms  proceeding  therefrom  arrogated  to 
some  abnormal  condition  of  the  brain.  It  is  not  for  me 
to  deny  that  certain  conditions  of  the  brain  or  its  coverings 
may  give  rise  to  symptoms  simulating  those  aroused  by 
a  gorged  stomach.  Nevertheless,  I  feel  it  is  only  right 
to  point  out  that  in  many  cases  a  searching  inquiry  into 
the  history  will  plainly  indicate  that  many  of  these 
attacks  have  the  origin  of  their  symptoms  in  an  abnor- 
mally gorged  condition  of  the  stomach.  Unless  we  are 
fully  decided  upon  this  point,  our  treatment  of  a  particular 
case  is  sure  to  be  at  fault. 

Causes. — Remembering  the  inability  of  the  horse  to 
vomit,  we  shall  not  be  surprised  to  find  that  excessive 
cramming  of  the  stomach  after  a  long  fast  is  a  frequent 
factor  in  determining  this  complaint.  It  is  not,  however, 
so  much  the  quantity  of  food  that  needs  consideration  as 
its  nature.  A  plentiful  supply  of  succulent,  easily-bolted 
herbage  is  the  one  food  that  is  extremely  likely  to  bring 
on  an  attack.  It  matters  not  whether  the  herbage  be 
rye-grass,  clover,  vetches,  or  ordinary  mixed  pasture, 
this  fact  remains  :  An  unlimited  supply  of  tasty,  suc- 
culent provender  will  cause  some  animals  to  go  on  feeding 
long  after  their  actual  wants  are  satisfied,  and  the  result 
is  an  impacted  state  of  the  stomach  with  a  mass  of  food 
it  is  unable,  mostly  mechanically,  to  deal  with. 

Regarding  what  has  been  written  concerning  some 
narcotic  quality  of  over-ripe  grasses  (Dick),  I  am  quite 


GASTRIC  IMPACTION  49 

prepared  to  grant  that  in  some  cases  such  may  be  the 
exciting  cause.  That  admission,  however,  does  not 
detract  one  iota  from  what  I  have  already  said.  If  one 
is  to  always  accept  that  explanation  of  the  case,  how  is 
one  to  account  for  those  odd  attacks  occurring  in  the 
winter  months,  when  the  whole  of  the  provender  is  dry 
corn  and  chopped  wheat  or  oat  straw  ?  I  have  seen 
cases  where  the  diet  was  wholly  composed  of  the  foods 
I  have  mentioned. 

Again,  how  is  it  that  one  animal  out  of  five  or  six,  all 
eating  the  same  food  from  the  same  manger,  is  sometimes 
seen  to  be  attacked  ?  No  explanation  of  the  latter  case 
can  be  found  save  the  fact  that  the  animal  under 
observation  is  a  notoriously  *  greedy  feeder.' 

Symptoms. — Percivall  sagely  remarks  :  '  The  un- 
naturally filled  stomach  produces  for  the  first  time  a 
sense  of  satiety ;  the  horse  grows  heavy  and  drowsy, 
reposes  his  head  upon  the  manger,  falls  asleep,  and  makes 
a  stertorous  noise.' 

His  whole  appearance  is  dull  and  listless,  and  the 
abdomen  is  visibly  distended,  though  not  to  the  extent  of 
causing  pain.  The  pulse  becomes  full  and  bounding 
and  its  number  of  beats  below  the  normal,  while  the 
respirations  are  heavy  and  slow.  The  bowels  become 
more  or  less  torpid,  though  the  rectum  is  frequently 
found  full  of  faecal  matter.  The  torpidity  seldom  or 
never  runs  the  length  of  actual  stasis  or  obstruction. 
Commonly  the  visible  mucous  membranes  are  injected 
and  tinged  with  yellow.  The  mouth  is  dry  and  clammy, 
and  its  odour  offensive.  There  are  no  eructations  of  gas 
and  no  attempts  at  vomition.  When  urged  to  move,  the 
animal  does  so  in  a  semi-unconscious  manner,  reeling 
and  staggering  in  his  walk,  and  blundering  blindly  into 
any  object  near  him. 

4 


50  THE  COMMON  COLICS  OF  THE  HORSE 

Allowed  to  stand,  he  remains  quiet,  with  head  down 
and  eyes  half  closed,  a  sudden  rousing  causing  him  almost 
to  fall  to  the  ground. 

Diagnosis. — Knowing  that  symptoms  like  the  above 
may  be  the  result  of  some  lesion  in  the  brain  itself,  the 
veterinarian  is  urged  to  make  a  careful  inquiry  into  the 
history  of  his  case.  That  done,  the  diagnosis  becomes  a 
comparatively  simple  matter.  Receiving  an  account  of 
an  abundant  feeding  after  a  long  fast,  learning  that  the 
animal  has  been  in  a  position  to  glut  himself  with  food  of 
which  he  is  especially  fond,  or  hearing  that  he  is  always 
a  voracious  and  greedy  feeder,  will  lead  the  veterinary 
surgeon  to  be  on  the  alert.  Either  of  these  circum- 
stances, together  with  the  symptoms  presented,  will 
render  any  chance  of  error  small.  Proceeding  further, 
and  by  negative  reasoning  placing  aside  this  and  that 
article  of  diet  as  containing  no  narcotic  principle,  the 
surgeon  advances  with  his  diagnosis,  and  finally  arrives 
at  a  correct  decision. 

Prognosis. — My  experience  leads  me  to  the  con- 
viction that  this,  in  most  cases,  may  be  favourable. 
The  absence  of  tympany  and  the  continuance  of  peri- 
stalsis, though  it  be  but  slight,  justifies  that  statement. 

Treatment. — This  must  be  mainly  directed  to  the 
conservation  and  assistance  of  such  favourable  conditions 
as  are  present.  It  should  be  borne  in  mind  that  the 
occurrence  of  tympany  would  quickly  lead  to  a  rapid  and 
fatal  termination. 

An  agent  which  will  be  found  to  prevent  that,  act  as 
an  antiseptic,  and  exert  an  excito-secretory  action  on  the 
intestinal  tract,  is  to  be  found  in  sodium  chloride.  Should 
that  be  the  drug  selected,  it  may  be  given  either  in  the 
form  of  a  ball  or  a  draught.  Those  who  prefer  it  may 
use   instead    hydrochloric    acid  in  small  and  frequently 


GASTRIC  IMPACTION  51 

repeated  doses,  taking  care  to  keep  it  well  diluted. 
The  administration  of  these  two  drugs  will  be  best 
followed  by  the  exhibition  of  an  oleaginous  purgative. 
It  will  act  beneficially  in  two  ways,  serving  both  to 
empty  the  overladen  bowels  and  to  counteract  any 
irritant  or  corrosive  effects  of  the  salt  or  acid.  The 
lethargy  of  the  nervous  system  should,  at  the  same  time, 
be  overcome  by  the  judicious  use  of  nux  vomica,  in 
this  case  preferably  given  in  the  form  of  the  tincture, 
owing  to  the  likelihood  of  its  becoming  more  rapidly 
absorbed. 

Another  and  perhaps  more  suitable  line  of  treatment 
is  the  administration  of  an  aloetic  purgative,  together 
with  the  use  of  the  alkaline  stimulants  (ammonia  com- 
pounds), which,  while  acting  as  cerebro-spinal  stimulants 
and  urging  the  circulatory  and  secretory  organs  into 
activity,  also  prevent  the  formation  of  gases. 

In  all  cases,  no  matter  what  the  medicinal  agent  em- 
ployed, the  animal  should  be  well  rugged  down,  in  order 
to  promote  warmth  and  the  action  of  the  remedies 
adopted.  At  the  same  time,  he  should  be  kept  slowly 
walking  to  overcome  the  lethargy  and  tendency  to  som- 
nolence. The  use  of  copious  warm  and  stimulating 
enemata  is  beneficial,  and  should  always  be  persisted  in. 


4—2 


CHAPTER  VII 

GASTRIC  TYMPANY:    GASTRECTASIS,  OR 
DILATATION  OF  THE  STOMACH 

Definition. — That  condition  of  the  stomach  in  which 
it  is  abnormally  distended  with  gas,  the  result  of  fer- 
mentation of  its  contents  or  the  introduction  of  air  from 
without. 

This  disease,  by  no  means  a  rare  one,  appears  to  have 
been  but  little  noticed  by  veterinarians,  if  we  may  judge 
by  the  paucity  of  literature  relating  to  it.  A  redeemnig 
feature  presents  itself  in  that  the  reported  cases,  though 
few  in  number,  are  extremely  well  stated,  and  leave  no 
doubt  in  the  mind  of  the  reader  that  the  authors  are 
well  acquainted  with  the  condition  they  describe,  cog- 
nisant of  the  real  nature  of  the  complaint,  and  convinced 
of  the  dangers  attending  it. 

Of  all  the  gastric  and  intestinal  disorders  we  are  able 
to  diagnose  this  is  one  of  the  most  rapid,  and  at  times 
one  of  the  most  fatal,  the  veterinary  surgeon  is  likely  to 
meet  with.  The  patient  is  in  those  extreme  agonies  of 
pain  that  quickly  run  on  to  death,  and  nothing  but  a 
prompt  recognition  of  his  complaint  and  the  administra- 
tion of  suitable  remedies  will  bring  about  a  favour- 
able issue.  A  few  hours'  indecision  will  place  his 
chances  of  life,  already  small,  beyond  all  hope.  This 
latter  statement  is  rendered  the  more  important  by  the 


GASTRIC  TYMPANY  53 

fact  that  the  attack  is  oftentimes  treacherous  at  the  out- 
set, the  mildness  of  the  premonitory  symptoms  effectually 
masking  all  possibility  of  the  fearful,  agonizing  spasms  to 
follow. 

Percivall,  though  including  both  this  disorder  and 
intestinal  tympany  in  one  description,  still  manages  to 
steer  clear  of  ambiguity,  and  leaves  his  reader  fully  in- 
formed that  tympany  of  the  stomach,  and  stomach  only, 
is  often  to  be  dealt  with  in  veterinary  practice.  He  says  : 
'  In  the  horse,  however,  who  has  no  rumen,  veritable  hove 
is  a  rare  occurrence.  ...  I  shall  never,  probably,  see  so 
many  blown  or  hoven'^  horses  as  I  witnessed  in  the  march 
of  the  British  army  from  Waterloo  to  Paris  in  181 5.  A 
brigade  of  horses  had  been  allowed  to  feed  in  a  field  of 
growing  wheat,  and  the  consequences  were  that  several 
amongst  them  swelled  in  the  body,  and  turned  almost 
frantic  with  pain,  and  died.' 

Other  authors  have  also  given  excellent  descriptions  of 
this  disorder.  Mr.  Henry  Thompson,  Aspatria,  under 
'  Rupture  of  Stomach  '  beautifully  describes  a  case  which 
had  its  starting-point  in  this  condition.  Here  is  his 
description :  '  This  horse  was  reported  ill  about  ten 
o'clock  in  the  morning,  and,  on  examining  him,  I  found 
that  he  was  apparently  suffering  ixom  flatus}  .  .  .  Treat- 
ment was  continued,  but  without  any  beneficial  effect, 
and  early  in  the  afternoon  the  "  eructation  "  was  noticed, 
the  pulse  rapidly  assumed  the  "  running  down  "  character, 
great  prostration  came  on,  and  the  horse  died  about 
eight  o'clock  in  the  evening.  From  the  time  when  the 
eructation  appeared  no  medicine  was  given,  as  from  my 
experience  in  former  cases  I  was  as  certain  as  it  was 
possible  to  be  that  a  rupture  had  occurred.'- 

^  The  italics  are  mine. — H.  C.  R. 
■•^  Veterinary  Jo uy mil,  vol.  iii.,  p.  259. 


54 


THE  COMMON  COLICS  OF  THE  HORSE 


Mr.  Alfred  Broad,  too,  relates  a  case  of  acute  gastric 
tympany  followed  by  recovery .^  It  is  noticed  also  by 
Messrs.  E.  Wallis  Hoare,  Cork^;  John  Young,  Edin- 
burghS;  and  R.  Shaw  Craig."*  These  writers  all 
distinctly  recognise  this  condition  of  distended  stomach. 

Causes. — As  is  the  rule  with  cases  of  equine  colic,  we 
may  conlidently  look  to  dietetic  errors  as  the  main  factor 
in  the  causation  of  this  complaint.  Those  in  country 
practice  may  expect  the  bulk  of  their  cases  from  the  hasty 
bolting  of  a  quantity  of  young  and  succulent  herbage, 
particularly  clover,  growing  corn,  lucerne,  or  vetches. 
Other  cases  will  occasionally  crop  up  where  the  animals 
have  been  allowed  a  large  quantity  of  mixed  ground 
corn.  These  attacks  are  frequent,  too,  in  localities 
where  animals  are  turned,  fresh  from  a  winter's  stabling, 
on  to  a  field  of  young  spring  grass,  more  especially  if  the 
pasture  be  marshy. 

In  some  districts  it  is  customary,  immediately  after 
harvest,  to  put  by  a  number  of  unthreshed  oat-sheaves, 
which  are  cut  up  and  used  as  chaft',  with  or  without  the 
admixture  of  other  seasoned  hay.  This,  again,  is  a  cause 
of  numbers  of  cases  of  tympanitic  stomach.  The  same 
may  be  said  of  newly- threshed  oats. 

Where  such  palpable  causes  as  these  are  absent  the 
practitioner  must  look  with  suspicion  upon  food  that  has 
been  badly  harvested — mow-burnt  hay  and  mouldy  corn. 
Personally,  I  am  not  an  advocate  for  the  use  of  boiled 
foods,  and  look  upon  them  as  a  frequent  cause  of  colic 
troubles.  Such  foods,  unless  the  men  are  well  superin- 
tended and  the  supplies  kept  fresh,  will  turn  sour  and 
inevitably  give  rise  to  fermentation  when  eaten.    For  the 

1  Veterinary  Journal,  vol.  ii.,  p.  17^. 

•^  Veterinarian,  vol.  Ixix.,  p.  794.  ^  Ibid.,  vol.  xlviii.,  p.  593. 

*  Veterinary  Record,  vol.  ix.,  p.  214. 


GASTRIC  TYMPANY  55 

same  reason  the  use  of  steeped  barley  or  wheat  is  not  to 
be  advised,  while  wheat  or  barley  in  the  unsteeped  form 
may  be  looked  upon  as  a  poison. 

This  same  complaint,  though  not  in  an  acute  form, 
may  be  occasioned  by  the  vicious  habit  of  crib-biting; 
the  stomach  and  abdomen  become  visibly  distended,  colic 
pains  following  closely  after. 

Greedy  feeding  and  imperfect  mastication  of  food  may 
also  be  put  down  as  a  cause.  In  Mr.  Broad's  case  he 
distinctly  states  that  it  was  the  hasty  swallowing  of  oats 
in  an  unmasticated  state  which  produced  indigestion, 
this  giving  rise  to  tympanites  of  the  stomach  and  intes- 
tines. Mr.  Broad  also  relates  another  case  in  which  the 
most  serious  tympanites  resulted  from  the  eating  of 
'cinquefoil.' 

Other  and  rarer  causes  may  occasionally  be  found  in 
some  diseased  state  of  the  stomach,  giving  rise,  in  the 
first  place,  to  indigestion,  and,  secondly,  to  fermentation 
of  its  contents — e.g.,  the  ulcerative  condition  occasioned 
by  the  presence  of  large  numbers  of  bots,  gastric  calculi, 
etc. 

General  F.  Smith,  in  dealing  with  this  disorder,  quotes 
from  the  pen  of  Mr.  Gillespie  to  illustrate  the  dangers 
of  mouldy  food.^  I  cannot  do  better  than  repeat  it 
here. 

'  On  a  certain  morning  I  was  called  to  see  some  horses 
of  the  5th  Punjab  Cavalry  in  camp,  and  on  arriving  at 
the  lines,  about  250  yards  off,  found  several  horses  dead, 
and  others  apparently  dying  fast,  and  all  extremely  tym- 
panitic. Either  three  or  four  had  died  during  the  night, 
and  five  or  six  more  had  been  attacked,  but  some  so 
slightly  as  to  be  fit  to  go  to  the  lines  after  exercise. 

1  Pyocecdings  of  the  Fifth  General  Meeting  of  the  National 
Veterinary  Association,  p.  79. 


56  THE  COMMON  COLICS  OF  THE  HORSE 

*  I  remember  that  one,  when  about  to  receive  an  enema, 
went  down,  and  I  thought  it  was  all  over  with  him,  for 
he  looked  more  dead  than  alive.  However,  to  my  great 
surprise,  he  showed  a  desire  to  get  up,  and,  once  on  his 
feet,  he  was  kept  trotting  until  his  bowels  began  to  act, 
and  he  was  saved.  I  think  this  was  the  only  bad  case  that 
recovered.  I  blamed  the  grass  at  once,  and  got  a  sample, 
which,  from  mouldiness,  was  truly  enough  to  set  up  any 
amount  of  fermentation  in  the  internal  economy ;  and 
be  it  known  tympany  was  the  sole  cause  of  all  this 
mischief. 

'  I  attended  the  post-mortem  of  all  those  that  had  died, 
and  no  sooner  were  the  abdominal  walls  severed  than  the 
stomach,  and  sometimes  the  colon,  exploded  with  con- 
siderable noise,  scattering  the  contents  for  many  yards 
around. 

'  In  some  instances  there  were  traces  of  congestion  of 
the  mucous  membrane  of  the  intestines  (not  confined  to 
any  particular  point),  and  in  one  case  there  was  a  leaden 
colour  of  part  of  the  ileum.  I  looked  upon  the  immediate 
cause  of  death  as  being  suffocation.  The  pressure  on  the 
walls  of  the  stomach  must  have  been  enormous,  for  it 
split  like  a  bubble,  and  so  did  the  large  intestine,  but  the 
latter  only  burst  on  a  few  occasions.' 

Symptoms. — In  most  cases  these  will  be  fairly  well 
pronounced  before  the  arrival  of  the  veterinary  surgeon. 
Nevertheless,  I  must  again  warn  the  practitioner  that  the 
outset,  even  of  a  serious  attack,  may  be  comparatively 
simple.  The  horse  is  seized  with  colic  pains  soon  after 
the  offending  feed.  The  pulse  at  first  is  but  little 
quickened,  and  the  respirations  are  not  increased  to  any 
marked  extent.  As  a  consequence,  the  animal  is  treated 
in  the  usual  way  by  the  attendants  before  calling  in  skilled 
advice. 


GASTRIC  TYMPANY  57 

During  this  time  the  patient  has  been  gradually  getting 
worse,  the  pains  have  become  more  severe,  and  the 
tympany  more  marked.  The  owner  eventually  becomes 
alarmed,  and  the  veterinarian  is  sent  for. 

The  symptoms  now  presented  are  of  an  excessively 
alarming  nature.  The  unfortunate  animal  is  in  a  bath  of 
perspiration ;  his  countenance  is  suggestive  of  the  most 
agonizing  torture ;  and,  staggering  blindly  about,  he  is  a 
danger  to  himself  and  those  about  him.  His  pains  have 
rendered  him  unmanageable,  and  with  the  greatest  diffi- 
culty can  he  be  kept  upon  his  legs.  That  is  one  state  of 
affairs  that  meets  the  eye  of  the  surgeon. 

In  other  cases  a  totally  different  set  of  symptoms  will 
be  presented  for  his  inspection.  Instead  of  madly  flinging 
himself  down,  only  to  rise  and  rush  in  frenzy  round  his 
box,  the  poor  brute  stands  in  patient  agony.  He  appears 
now  to  have  some  God-given  instinct  that  violence  will 
only  render  worse  his  well-nigh  hopeless  case.  He  occa- 
sionally makes  quiet  crouching  attempts  to  lie,  but  stands 
for  the  most  part  quiet.  The  distressed  nature  of  his 
respirations,  however,  and  the  pinched,  haggard  expres- 
sion of  his  countenance  reveal  the  intensity  of  his  suffer- 
ing, as,  with  appealing-looking  eyes,  he  turns  from  one 
to  the  other  of  those  standing  by  for  help  in  his  agony. 

In  both  cases  examination  reveals  an  alarming  state  of 
the  pulse  and  respirations.  The  pulse,  weak  in  character, 
is  found  to  be  hammering  frantically  at  a  rate  of  loo  to 
120  beats  a  minute,  and  the  breathing,  of  a  painful,  gasp- 
ing, see-saw  character,  is  accelerated  from  the  normal  to 
as  many  as  140  to  150. 

Oftentimes  the  abdomen  is  found  to  be  tensely 
tympanitic  ;  rarely,  it  will  be  found  to  be  about  the 
normal,  no  noticeable  distension,  and  peristalsis  evident 
on  auscultation.     In   those  cases  where  abdominal  dis- 


58  THE  COMMON  COLICS  OF  THE  HORSE 

tension  is  marked,  rectal  exploration  will  sometimes 
reveal  coils  of  distended  intestines  occupying  the  pelvis, 
and  the  operator's  arm  is  met  with  painful  straining 
efforts  on  the  part  of  the  patient.  At  times  the  rectum 
is  found  to  contain  a  few  hard  lumps. 

Distension  of  the  abdomen,  however,  is  not  a  constant 
symptom.  It  is  sometimes  almost  entirely  absent,  in 
which  case  what  tympany  there  is  will  be  seen  on  the 
left  side  and  fairly  well  forward.  My  experience  leads 
me  to  the  conviction  that  those  cases  in  which  the  bowels 
are  free  from  tympany  are  the  ones  that  yield  most  readily 
to  treatment. 

When  the  case  has  occurred  without  previous  feeding 
on  green  food,  careful  inquiries  will  elicit  the  fact  that 
the  passage  of  faeces  has  been  fairly  regular  throughout 
the  day,  and  that  the  pains  only  came  on  soon  after 
partaking  of  a  particular  feed.  The  most  striking  and 
most  diagnostic  symptom  is  the  frequent  eructation  of 
gas,  and  here  one  word  of  caution  is  necessary.  I  have 
called  it  '  eructation,'  possibly  giving  my  reader  to  under- 
stand that  large  volumes  of  gas  are  escaping  by  the 
oesophagus.  I  need  hardly  say  that  such  is  not  the  case, 
for,  if  that  were  happening,  the  animal  would  soon  gain 
natural  reHef.  In  the  great  majority  of  instances  the 
spasmodic  contraction  of  the  cervical  muscles,  the  retch- 
ing noise  emitted  by  the  patient,  and  the  gurgling  noises 
in  the  oesophagus  serve  to  relieve  the  patient  no  further 
than  the  expulsion  of  quite  a  small  quantity  of  gas,  and, 
at  times,  a  thin  trickhng  of  ingesta  from  the  nostrils. 

Should  relief  not  soon  be  obtained,  the  symptoms 
become  worse  still,  and  quickly  post  on  to  the  end.  The 
breathing  becomes  more  and  more  distressed ;  the 
abdomen  fills  further  and  further  with  gas,  and  the 
small  quantity  of  fluid  ejected  from  the  nostrils  increases 


GASTRIC  TYMPANY  59 

in  volume  until  it  becomes  a  disgusting  vomit.  Saliva 
hangs  in  strings  from  the  muzzle ;  the  gurgling  noise  in 
the  oesophagus  becomes  louder  and  more  frequent,  and  is 
further  augmented  by  the  rattling  of  fluid  ingesta  that 
has  gained  entrance  to  the  trachea ;  patchy  perspirations 
bedew  the  body,  and  the  whole  appearance  is  indicative 
of  the  greatest  concern  and  anxiety. 

Later,  the  animal  becomes  pulseless,  delirium  comes 
on,  and  he  staggers  unconsciously  round  and  round 
his  box. 

'  Doing  the  Dead  March  !'  mutters  the  veterinarian  to 
himself,  turning  aside  to  hide  his  vexation. 

Shortly  afterwards  the  poor  brute  expires  in  convul- 
sions, in  his  agony  clutching  the  ground  with  his  teeth, 
as  he  draws  his  final  gasps.  The  eyes  recede,  the  limbs 
stiffen,  and  the  patient  slave  has  finished  his  toil. 

Diagnosis. — When  the  case  is  fairly  well  advanced 
this  should  offer  no  great  amount  of  difficulty.  As  I 
have  stated  before,  attacks  of  tympanitic  stomach  are 
somewhat  deceiving  at  the  outset,  and  the  very  mildness 
of  the  early  symptoms  may  lead  the  veterinarian  to  look 
too  lightly  upon  his  case.  At  the  most,  however,  from 
one  to  two  hours  will  produce  unequivocal  symptoms, 
and  the  veterinary  surgeon  is  able,  with  all  confidence, 
to  set  about  treating  the  case. 

The  manner  in  which  the  diagnosis  may  be  proceeded 
with  is  something  after  this  fashion :  The  veterinarian 
finds  his  patient  so  frantic  with  pain,  so  bedewed  with 
sweat,  and  his  pulse  so  quickened  as  to  immediately 
suggest  that  dire  disease  '  enteritis.'  He  is  relieved  on 
that  score  by  an  examination  of  the  conjunctiva.  It  is 
not  of  that  '  raw-beef '  redness  so  invariably  associated 
with  that  fell  malady.  The  respiration  to  his  practised 
ear  suggests,  in  addition  to  pain,  something  of  suffocating 


6o  THE  COMMON  COLICS  OF  THE  HORSE 

pressure  on  the  diaphragm.  While  engaged  in  this,  the 
examiner  will  often  hear  sounds  of  peristalsis,  with  some- 
times the  passing  of  a  small  volume  of  flatus  per  anum. 
He  knows,  again,  that  in  enteritis  these  movements  and 
sounds  are  almost  always  entirely  absent.  The  eye, 
though  expressive  of  excruciating  pain,  has  not  the 
haggard  '  I'm  done  for '  kind  of  expression  that  the 
animal  in  the  fatal  grip  of  enteritis  always  shows. 

Having  dismissed  enteritis  from  his  calculations,  the 
field  of  error  is  considerably  reduced.  The  pains  are  not 
those  of  ordinary  impaction  of  the  stomach  or  intestines ; 
they  are  much  too  acute  in  character.  Is  it  twist, 
volvulus,  or  strangulated  hernia  ?  In  a  typical  case  of 
the  affection  even  these  serious-soundmg  suggestions  are 
easily  disposed  of.  The  abdomen  is  not  hard  enough, 
tense  enough,  tympanitic  enough  to  allow  of  such  an  idea 
being  seriously  entertained  for  long.  It  will  not  be  for- 
gotten, however,  that,  as  previously  stated,  the  abdomen 
may  be  tympanitic,  so  that,  to  assist  him  in  his  diagnosis, 
the  veterinarian  must  look  for  signs  more  convincing  still 
ere  he  comes  to  a  final  conclusion. 

Perhaps  he  has  punctured  the  abdomen,  and  still  finds 
tympany  remaining.  In  the  positions  in  which  he  has 
operated  he  knows  he  should  have  encountered  the 
caecum  and  colon.  He  knows  of  no  other  bowel  that  is 
able  to  distend  to  the  extent  that  his  case  presents.  He 
is  compelled,  and  rightly,  to  fall  back  on  the  stomach  as 
the  seat  of  mischief. 

He  is  struck  by  the  catchy,  see-saw  breathing,  and  the 
trickling  fluid,  small  in  quantity,  running  from  the 
nostrils.  He  auscultates  the  trachea,  and  obtains  distinct 
evidence  of  fluid  in  that  passage.  The  idea  of  an  inspired 
drench  is  emphatically  negatived  by  the  owner  and 
attendants;    sometimes,    even,    one    has   not    been    ad- 


GASTRIC  TYMPANY  6i 

ministered.  The  balance  of  evidence,  even  now  inclining 
heavily  towards  '  stomach  trouble,'  is  weightily  dropped 
by  the  exhibition  of  a  definite  and  characteristic  set  of 
symptoms  on  the  part  of  the  patient.  There  is  an 
entirely  involuntary  regurgitation  of  the  oesophagus,  with 
a  peculiar  gurgling,  bubbling  noise  in  the  chest,  as,  with 
a  suppressed  squeal  of  pain,  and  a  slight  depression  of 
the  head,  the  animal  exudes  a  small  quantity  of  ingesta- 
stained  flfuid  from  the  nostrils. 

The  veterinary  surgeon  knows  now  he  has  a  case  of 
tympanitic  stomach,  and  that  a  bad  one,  on  his  hands. 
Should  it  happen,  however,  that  he  is  only  partly  con- 
vinced, he  will  be  made  more  certain  still  by  closely 
watching  the  animal's  movements.  The  act  of  lying 
down  is  performed  with  care,  and,  should  his  case 
fortunately  be  uncomplicated  by  intestinal  tympany, 
he  will  notice  -distinct  signs  of  tympany  right  forward, 
under  the  last  rib,  on  the  left  side.  In  addition  to  this, 
some  practitioners  have  observed  that  the  perspiration 
is  confined  to  the  left  side,  or  more  pronounced  over 
the  region  of  the  stomach.  I  cannot  say  that  I  have 
noticed  it. 

One  other  symptom,  and  that  a  fairly  diagnostic  one, 
still  remains.  When  down,  the  animal  sometimes  raises 
himself  on  his  fore  -  feet,  and  sits,  dog  -  like,  on  his 
haunches.  Mr.  Broad  of  Bath  has  declared  that  to  be 
almost,  if  not  quite,  diagnostic  of  stomach  affection.  He 
says  :  '  Sitting  on  the  haunches  has  its  diagnostic  value ; 
it  indicates  the  seat  and  nature  of  the  pain  evinced — that 
is,  overdistension  of  the  stomach  and  anterior  part  of 
colon,  or  both — the  horse  taking  this  position  to  relieve 
the  diaphragm  of  their  weight  and  pressure.' 

With  a  set  of  symptoms  like  the  above  the  veterinary 
surgeon  should  have  no  great  difficulty  in  summing  up 


62  THE  COMMON  COLICS  OF  THE  HORSE 

his  case.     Even  should  only  one-half  of  them  be  exhibited, 
a  right  understanding  should  be  arrived  at. 

There  is  another,  and  more  grave  condition,  however, 
which  may  so  closely  simulate  tympanitic  stomach  as  to 
lead  to  serious  error.  I  refer  to  twist  of  the  double 
colon,  at  either  its  sternal  or  diaphragmatic  flexure,  or 
both.  It  is  in  the  elimination  of  this  possibility  that  the 
greatest  difficulty  in  the  way  of  a  correct  diagnosis  lies. 
An  animal  in  which  that  condition  is  present  will,  during 
the  first  pains  arising  from  it,  exhibit  signs  that  even 
the  most  skilled  may  be  excused  for  confounding  with 
flatulent  stomach.  There  is  the  same  quick  pulse,  80  to 
90,  or  120;  the  same  catchy,  see-saw  breathing;  the 
same  signs  of  attempted  eructation,  and  the  same  ingesta- 
stained  fluid  running  from  the  nose.  Everything  seems 
in  order,  and  the  case  is  treated,  as  its  symptoms  appear 
to  warrant,  for  gastric  tympany. 

Six  to  eight  hours  elapse,  and  the  practitioner  pays 
another  visit.  He  finds  the  symptoms  no  whit  abated, 
and  recognises  the  case  is  a  dangerous  one.  Even  on 
his  first  visit  he  had  been  struck  by  the  intense  redness 
of  the  conjunctiva.  This  has  increased  now  to  a  condi- 
tion resembling  that  seen  in  the  disease  known  as 
enteritis,  and  the  pulse  has  grown  weaker  and  faster  than 
before.  Still — and  this  is  the  circumstance  that  leads 
first  to  wonder,  and  then  to  an  alteration  in  the  diagnosis 
— the  animal  spends  a  great  deal  of  his  time  in  a  re- 
cumbent position.  Reared  upon  his  chest,  he  lies  in 
apparent  half-comfort.  Were  it  not  for  the  redness  of 
the  conjunctiva,  and  the  peculiar  catching  sob  that  is  now 
taking  place  with  each  respiration,  his  position  would 
indicate  ease.  In  other  words,  his  pains,  on  a  first 
glance,  would  come  under  the  category  of  *  dull,'  and  be 
thus  correctly  referred  to  the  colon. 


GASTRIC  TYMPANY  63 

But  why  the  stomach  symptoms  ?  They  are  there  in 
alarming  abundance,  and  the  practitioner  feels  bound  to 
treat  them. 

The  third  and  fourth  visits  find  the  same  symptoms 
present,  but  the  animal  visibly  weaker.  Twenty-four  to 
forty-eight  hours  sees  the  end. 

While  writing  this  I  have  a  case  in  my  mind  which 
ran  an  exactly  similar  course  to  the  one  described  above. 
It  was  treated  for  gastric  tympany,  and  its  real  nature 
unsuspected  until  the  expiration  of  twelve  to  twenty-four 
hours.  It  was  then  apparent  that  some  serious  condition 
was  impeding  the  egress  of  food  from  the  duodenal  end 
of  the  stomach,  and  the  possibility  of  the  presence  of 
twist  was  suggested  to  the  owner.  It  was  even  ventured 
to  locate  the  seat  of  twist  as  the  duodenum.  The  end 
of  the  second  day  saw  the  death  of  the  animal,  and 
a  post-mortem  examination  cleared  things  up  satisfac- 
torily. 

The  double  colon  was  twisted  two  or  three  times  upon 
itself  in  the  position  of  the  sternal  and  diaphragmatic 
flexures,  thus  completely  shutting  off  the  second  and 
third  portions  of  the  bowel  from  the  first  and  fourth. 

In  that  portion  of  the  bowel  immediately  anterior  to 
the  twist  was  a  huge  mass  of  accumulated  ingesta.  This 
was  lying  in  close  apposition  with  and  pressing  on  the 
stomach,  accounting  to  some  extent,  no  doubt,  for  the 
preponderance  of  stomach  symptoms  that  presented  so 
perplexing  a  part  of  the  history  of  the  case. 

It  will  be  seen  from  this  that  the  utmost  care  is 
necessary  when  giving  a  diagnosis  of,  or  foretelling  the 
issue  of,  a  case  of  tympanitic  stomach.  In  the  majority 
of  cases  the  symptoms  I  have  described  will  lead  the 
practitioner  to  a  correct  estimate  of  his  patient's  con- 
dition.    He  should  never  forget,  however,  the  possibility 


64  THE  COMMON  COLICS  OF  THE  HORSE 

of  twisted  colon,  and  should  take  care  that  his  examination 
of  the  sufferer  is  a  long  and  searching  one. 

The  only  signs  that  will  serve  to  distinguish  the  two 
complaints  are  the  following :  The  palpable  stomach 
symptoms  must  be  laid  aside  for  the  minute,  and  a  great 
deal  of  reliance  placed  upon  the  one  symptom  of  the 
animal's  desire  to  lie  about  for  lengthy  periods.  In  a 
typical  case  of  tympanitic  stomach  that  does  not  occur. 
The  respirations,  in  addition  to  being  catchy  and  see-saw 
in  their  character,  are  added  to  by  a  plain  and  unmis- 
takable sob — not  a  gasp  for  breath  owing  to  pressure  on 
the  lungs,  but  a  sob  of  pain.  Finally,  the  gradual  in- 
crease of  the  conjunctival  mucous  membranes  in  redness 
and  the  fatal  indications  afforded  by  the  quickened  and 
fastly  weakening  pulse  will  lead  one,  a  few  hours  after  the 
commencement  of  the  attack,  to  a  knowledge  of  its  true 
nature. 

Prognosis. — It  may  be  said  that  all  cases  of  tym- 
panitic stomach,  especially  when  the  tympany  is  of  such 
an  extent  as  to  be  easily  diagnosed,  offer  a  grave  element 
of  danger.  Anatomical  reasons,  already  discussed  in 
Chapter  II.,  warrant  one  in  that  statement.  When  the 
tympany  of  the  stomach  is  accompanied  with  impacted 
or  tympanitic  intestines,  it  is  always  wise  to  warn  the 
owner  that  the  case  may  have  a  fatal  termination.  When 
the  tympany  is  confined  to  the  stomach,  the  abdomen 
fairly  flaccid,  and  the  bowels  acting,  a  more  favourable 
issue  may  with  safety  be  prophesied,  always  reserving 
the  promise  by  indicating  the  likely  finish,  should  tympany 
of  the  intestines  supervene.  A  further  reservation  will 
also  have  to  be  made  in  the  very  early  stages  of  the  case 
when  allowing  for  the  condition  of  twisted  colon.  The 
owner  may  safely  be  advised  that  a  few  hours  will  settle 
the   question.     Either  his   case    of    stomach    tympany. 


GASTRIC  TYMPANY  65 

under  suitable  treatment,  will  begin  to  mend,  or  the  fatal 
and  unequivocal  signs  of  twist  be  in  evidence. 

Again,  it  is  always  policy,  when  dealing  with  a  case  of 
this  description,  to  point  out  the  probability  of  rupture 
occurring.  The  veterinarian  may,  with  all  justice,  inform 
his  client  that  vomiting  is  not  necessarily  a  sign  that  such 
has  already  taken  place.  It  is  impossible  to  diagnose 
this  lesion  until  its  fatal  signs  are  present  (see 
Chapter  VIII.),  and  the  veterinary  surgeon  may  con- 
fidently proceed  to  treat  his  case,  promising  to  advise 
his  client  immediately  symptoms  of  an  alarming  nature 
present  themselves. 

Treatment. — This  offers  to  the  veterinarian  one  or  two 
interesting  little  problems.  Primarily,  the  lines  upon 
which  he  may  start  and  upon  which  his  treatment  must 
be  based  are  simple  indeed.  They  may  be  succinctly 
summed  up  in  these  two  immediate  instructions:  (i)  Rid 
the  stomach  of  gas  already  present.  (2)  Prevent  the 
formation  of  any  more. 

Before  attempting  to  dispose  of  the  gases,  it  is  neces- 
sary to  know  their  composition.  Recent  experiments 
have  shown  that  those  which  bulk  most  largely  in  the  dis- 
tended stomach  are  carbonic  acid,  carburetted  hydrogen, 
sulphuretted  hydrogen,  and  nitrogen,  the  nitrogen  form- 
ing only  a  small  proportion.  As  carburetted  hydrogen 
cannot  conveniently  be  absorbed  by  any  vehicle  which 
may  be  administered  pev  orem,  our  remedial  agents 
must  be  mainly  directed  against  carbonic  acid  and 
sulphuretted  hydrogen.  We  are  again  compelled  to 
fall  back  upon  what  may  be  regarded  as  the  veterinary 
surgeon's  sheet-anchor  in  the  treatment  of  the  equine 
colics — ammonia.  In  this  case,  however,  the  success  of 
the  treatment  will  entirely  depend  upon  what  form  of 
ammonia  is  used, 

5 


66  THE  COMMON  COLICS  OF  THE  HORSE 

In  this  particular  instance  the  use  of  the  carbonate 
would  be  well-nigh  fatal :  and  this  is  the  reason.  We 
may  safely  assume  with  a  tympanitic  stomach  that  we 
have  an  acid  condition  of  its  contents.  That  being  so, 
the  administered  carbonate  would,  by  the  action  on  it  of 
the  acid,  be  caused  to  evolve  carbonic  acid,  and  add  still 
further  to  the  volume  of  that  gas  already  in  the  stomach. 

The  form  of  ammonia  indicated  is  the  solution  of 
ammonium  hydrate  (the  liquor  ammoniae  fort,  of  the 
pharmacopoeias),  because  by  its  exhibition  the  carbonic 
acid  gas  present  in  the  stomach  will  readily  be  absorbed 
(to  form  ammonium  carbonate),  while,  with  a  suitable 
addition  (as,  for  example,  iron  or  bismuth)  the  sul- 
phuretted hydrogen  may  also  be  combined,  and  caused 
to  leave  its  gaseous  form,  thus  greatly  lessening  the 
volume  of  gases  in  the  stomach.  Such  an  admixture  is 
easily  prepared  as  follows  : 

Ferri  sulph.  pulv.  -         -         -         -        gi. 
Aqua  (fervens)        ....         Oil. 
Liq.  ammon.  fort.  -         •         -        Siv.-' 

This  mixture,  with  its  resulting  precipitate,  should  be 
administered  at  once.  The  freshly  precipitated  hydrate 
of  iron  combines  with  the  sulphuretted  hydrogen,  while 
the  free  ammonia,  still  exerting  its  stim.ulant  and  anti- 
spasmodic actions,  absorbs  the  carbonic  acid. 

This  is  the  treatment  I  would  recommend  as  the  most 
suitable  for  disposing  of  the  accumulated  stomach  gases. 
This  done,  it  is  wise  to  follow  on  with  the  exhibition  of 
some  form  of  mild  antiseptic,  one  with  stimulant  pro- 

1  One  word  is  necessary  in  order  to  explain  the  apparently 
excessive  dose  of  liq.  ammon,  fort.  An  estimated  3  drachms  of 
that  goes  to  the  formation  of  hydrate  of  iron,  thus  leaving  really 
only  I  drachm  of  free  ammonia  for  stimulant  and  antispasmodic 
purposes. — H.  C.  R, 


GASTRIC  TYMPANY  67 

perties  preferred — e.g.,  terebene,  ol.  tereb.,  or  water 
strongly  impregnated  with  ol.  menth.  pip.  Either  of 
these  will  tend  to  stay  the  fermentation  going  on  in  the 
stomach,  and  render  the  evolving  of  further  gas  from  the 
mass  unlikely. 

It  is  usual  with  most  practitioners  to  combine  with  the 
ammonia  a  carminative  and  sedative  ;  also  to  administer 
at  the  same  time  an  aloetic  purgative.  As  fair  samples 
of  the  man}'  drenches  so  given,  I  select  the  following : 


.  Tinct.  opii 

-    Bi. 

2.  Terebene  pur.    - 

-    5ii. 

Spt.  ammon.  ar 

-    Bi. 

Chlorodyne 

.    5iv. 

Ether  sulph. 

-     5iv. 

Spt.  eth.  nit.      - 

-    5ii. 

Aloes  sol.  - 

-    5vi. 

01.  lini       - 

-    Oiss 

01.  lini       - 

-     Oss. 

These  two  drenches  are  both  open  to  serious  objection. 
No.  I  more  so  than  No.  2.  In  No.  i  the  only  medicine 
at  all  calculated  to  act  on  the  stomachic  gases  is  the  spt. 
ammon.  ar.  The  amount  of  free  ammonia  in  that  pre- 
paration, however,  is  not  enough  to  work  any  beneficial 
result  unless  given  in  far  greater  doses  than  there  laid 
down,  while,  if  given  in  large  doses,  its  greater  proportion 
of  contained  ammonium  carbonate  will  act  adversely,  as 
before  described. 

Drench  No.  2  offers  us  a  useful  antiseptic  in  the  form 
of  terebene.  This,  in  all  probability,  will  prevent  the 
formation  of  any  further  gas  than  that  already  in  the 
stomach.  That  it  will  effectually  dispose  of  the  volume 
already  there,  and  so  relieve  the  distended  stomach,  is,  to 
say  the  least  of  it,  highly  problematical. 

In  these  draughts  the  ingredients  to  which  I  take 
serious  exception  are  the  opium  and  the  chlorodyne  with 
its  contained  morphia  and  mixture  of  other  and  various 
sedatives.  I  most  strongly  advise  all  and  everyone  to 
avoid,  as  they  would  avoid  poison,  giving  sedatives  to  the 

5—2 


6S  THE  COMMON  COLICS  OF  THE  HORSE 

horse  with  coHc — what  form  of  colic  matters  but  Httle, 
unless  accompanied  with  violent  purging. 

By  all  means  adopt  any  other  part  you  wish  of  the 
treatment  here  laid  down.  Give  aloes,  even,  if  you  are 
so  inclined,  though  that  is  useless  and  unnecessary.  But 
if  you  earnestly  wish  your  list  of  successful  cases  to 
increase,  if  you  wish  to  give  satisfaction  to  yourself  and 
to  your  client,  give  the  widest  possible  berth  to  sedatives. 
Leave  them  severely  alone.  My  reasons  for  this  advice 
will  be  found  more  fully  stated  in  the  chapter  on  Intestinal 
Impaction. 

Applying  this  advice  to  the  disorder  we  are  now  dis- 
cussing, we  shall  find  the  explanation  simple  enough,  thus : 

We  have  a  horse  with  his  stomach  enormously  distended  ivith 
gas.  In  all  probability  its  distension  is  materially  assistifig 
in  the  closure  of  the  duodenal  trap  (see  Chapter  II.,  Figs.  2 
and  ^)  by  the  mere  force  of  presstire.  We  have  already  shown 
(Chapter  IV.,  p.  28)  that  the  horse  is  anatomically  unable  to 
adequately  relieve  himself  by  way  of  the  oesophagus.  Ergo, 
the  only  natural  relief  we  can  possibly  hope  for  is  the  imloching 
of  the  duodenal  trap  by  violent  and  energetic  intestinal  movements. 
And  these  movements  the  practitioner  proposes  to  altogether 
restrict  by  administering  a  dose  of  opium.  .  .  .  Not  only  is 
that  unreasonable — it  is  criminal.  Were  our  patient  a  human 
being  it  would  be  considered,  and  rightly  considered,  slaughter. 

It  is  no  mere  fad  of  mine,  this  wholesale  condemnation 
of  the  use  of  sedatives  in  equine  colic.  It  is  the  outcome 
of  many  an  unconscious  experiment,  the  fruit  of  much 
bitter  experience,  and  the  careful  weighing  together  of 
the  data  so  obtained.  I  would  ask  all  who  seriously  read 
my  little  volume  to  give  the  most  weighty  and  thought- 
ful consideration  to  the  paragraph  immediately  preceding 
this.  The  matter  it  contains  is  small  in  bulk,  but  offers 
much  food  for  quiet  reflection. 


GAstttlC  TYMPANY  69 

I  have  said  that  the  only  possible  natural  means  of 
relief  we  can  hope  for  is  the  unlocking  of  the  duodenal 
trap  by  violent  and  energetic  intestinal  movements. 
Nature  may  be  assisted  in  bringing  that  happy  state  of 
affairs  about,  and  it  is  the  veterinary  surgeon's  manifest 
duty  to  so  assist  her  by  giving  his  patient  a  dose  of 
eserine  and  pilocarpine,  or  any  other  drug  that  will 
stimulate  the  involuntary  muscle  of  the  intestines  into 
immediate  action.  For  my  own  part,  in  whatever  way  I 
have  treated  the  stomach  gases  by  per  orem  remedies,  I 
have  always  administered  with  the  happiest  results  a 
simple  hypodermic  dose  of  eserine  sulphate  (2  grains 
to  2^  grains).  When  it  acts,  it  is  surprising  to  note, 
although  the  abdomen  is  previously  not  tympanitic,  the 
immense  volumes  of  flatus  that  are  passed  per  annm. 
After  only  an  hour's  severe  pain,  its  effect  is  complete 
and  lasting  relief.  As  illustrative  of  its  beneficial  action, 
I  will  quote  the  following  case  occurring  in  my  own 
practice. 

September  16,  11  p.m. — I  was  called  to  a  farm  6  miles 
distant  to  attend  a  heavy  cart  mare.  The  following 
history  of  the  case  was  quickly  obtained.  The  patient 
had  left  the  stable  at  6.45  a.m.  in  her  usual  good  health, 
had  been  at  plough  all  day,  and  was  returned  to  the 
stable  at  3.45  p.m.,  and  given  a  full  feed  of  chopped  new 
oat  straw  and  Indian  corn.  Immediately  after  this  she 
was  put  to  work  at  a  circular  chaff-cutting  machine, 
following  upon  which  she  was  quickly  taken  ill.  I  found 
the  poor  brute  in  agonies  of  pain  (far  too  bad  to  roll), 
pulse  120,  respirations  enormously  quickened,  and  of  a 
gasping  see-saw  nature,  and  a  temperature  of  103°  F. 
The  rectum  contained  a  few  hard  lumps  and  was  non- 
contracting  ;  there  was  no  abdominal  distension ;  the 
other  bowels  were  fairly  empty,   and  auscultation  gave 


70  THE  COMMON  COLICS  OF  THE  HORSE 

slight  evidence  of  peristalsis.  With  each  respiration 
there  was  a  peculiar  forward  movement  of  the  oesophagus, 
with,  every  now  and  again,  distinct  sounds  of  attempted 
eructation.  There  was  no  ingesta  returning  through  the 
nostrils,  and  yet  auscultation  of  the  trachea  revealed 
sounds  of  fluid  in  that  passage.  Inquiries  elicited  the 
fact  that  the  animal  was  choked  with  the  drinks 
administered  before  my  arrival. 

I  diagnosed  tympanitic  stomach,  with  inability  of  the 
pylorus  to  pass  it.  Having  administered  the  usual 
remedies,  I  resolved  to  at  once  empty  the  intestines,  for, 
seeing  that  I  had  already  obtained  slight  evidence  of 
peristalsis,  I  apprehended  no  difficulty  in  so  doing.  To 
that  end  I  administered  a  full  dose  of  eserine  sulphate 
(2  J  grains  hypodermically),  and  prepared  myself  to  watch 
results. 

Septemhev  17,  12.30  a.m. — The  end  of  half  an  hour  saw 
full  and  frequent  passage  of  tremendous  volumes  of  flatus 
pev  amim,  and  by  this  time  the  mare  was  distinctly 
relieved,  though  still  blowing  hard  from  the  effects  of  the 
inspired  drenches.  The  attempts  at  eructation  were  far 
less  frequent,  and  I  saw  that  I  had  now  overcome  the 
stomach  trouble.  I  gave  a  guarded  prognosis,  however, 
not  knowing  how  the  tracheal  disturbance  was  likely 
to  end. 

September  17,  10.30  a.m. — Mare  picking  at  provender. 
Entirely  free  from  colic  pains,  but  causing  grave  anxiety 
on  account  of  the  pulmonary  congestion.  The  usual 
remedies  were  administered,  and,  though  ailing  some 
days,  the  animal  made  an  uninterrupted  recovery. 

I  have  now  laid  down  a  simple  and  rational  treatment 
for  combating  this  distressing  disorder.  Before  closing 
the  chapter,  however,  it  is  my  duty  to  mention  two  other 
means  which  are  sometimes   discussed,  but  seldom   or 


GASTRIC  TYMPANY 


71 


never  practised.  I  am  referring  to  the  use  of  a  trocar 
and  cannula  on  the  stomach,  and  the  passing  of  an 
oesophagus-tube. 

I  think  that"  most  veterinarians  will 
agree  with  me  in  saying  that  puncturing 
the  stomach  is  not  without  a  grave  ele- 
ment of  danger,  and  therefore  not  to  be 
advised.  However,  should  tympany  of 
the  intestine  also  be  present,  the  opera- 
tion of  puncturing  the  bowels  should  be 
the  first  consideration.  It  is  simple, 
unattended  with  serious  risk,  and  imme- 
diately effectual  in  affording  instant 
relief. 

The  use  of  the  oesophagus  -  tube 
is  hardly  likely  to  come  into  vogue. 
It  was  first  suggested  by  Percivall, 
and  afterwards  advocated  by  General 
Smith.  That  it  would  afford  relief  if 
introduced  no  one  would  attempt  to 
deny.  As  General  Smith's  writings, 
however,  so  far  as  I  can  trace  them, 
leave  the  instrument  yet  '  imperfect,' 
the  veterinary  surgeon  must  either  ex- 
periment in  that  line  himself,  or  wait 
until  someone  has  further  improved  upon 
this    mechanical   means    of   treatment.^ 


Fig.  7.  —  D.  O. 
Knisely's 
Stomach-Tube. 


^  Since  the  above  was  written  I  have  received 
letters  from  two  American  practitioners,  the 
contents  of  which  are  at  any  rate  interesting  in 
this  connection.     I  give  them  here  : 

Dr.  A.  T.  Everett,  of  South  Omaha,  Nebraska,  to  whom  I  am 
indebted  for  Fig.  7,  says  :  '  With  reference  to  the  oesophagus-tube, 
which  you  say  is  as  yet  "imperfect,"  I  enclose  you  a  cut  of  a 
stomach-tube  invented  by  Mr.  D.  O.  Knisely,  which  seems  to  give 


72  THE  COMMON  COLICS  OF  THE  HORSE 

It  is  not  likely  to  be  adopted  by  the  average  prac- 
titioner as  a  principal  line  in  his  treatment,  for  these 
reasons :  It  is  rather  cumbersome,  adds  to  his  impedi- 
menta, and  can  only  be  required  in  quite  a  small 
percentage  of  the  cases  of  '  colic '  he  is  called  upon  to 
attend.  Whatever  treatment  the  practitioner  has  decided 
to  adopt,  let  him  carefully  remember  one  detail  of  the 
utmost  importance.  When  he  has  with  certainty 
diagnosed  tympany  of  the  stomach,  it  is  his  duty  to 
emphatically  warn  the  owner  and  attendants  of  the 
danger  the  horse  runs  if  allowed  to  roll.  It  is  extremely 
likely  to  bring  about  the  lesion  I  describe  in  my  next 
chapter,  rupture  of  the  stomach. 

excellent  results  in  the  hands  of  several  veterinarians  who  have  used 
one.  The  single  tubes  are  practically  useless,  as  they  block  up  with 
food  ;  and  a  man  using  one  throws  it  away  in  disgust.  With  this 
you  do  not  experience  this  trouble.' 

This  tube  here  illustrated  is  lo  feet  in  length,  is  double  for  7  feet, 
and  has  the  balance  in  separate  tubes. 

The  double  part  has  the  tube  cemented  together,  so  as  to  make 
the  outside  circumference  small  enough  to  be  readily  passed  through 
the  oesophagus  into  the  stomach.  The  large  opening  is  ^  inch 
across,  and  is  the  outlet  from  the  stomach  through  which  the 
food  and  the  gases  will  return.  The  smaller  opening  is  |  inch 
in  diameter,  through  which  water  is  passed  into  the  stomach.  This 
latter  procedure  is  presumably  to  aid  the  egress  of  the  food  through 
the  larger  tube. 

Dr.  T.  B.  Rogers,  of  Woodbury,  New  Jersey,  says  :  '  With  regard 
to  the  passing  of  the  stomach-tube,  this  is  now  a  standard  procedure 
with  our  more  scientific  practitioners,  and  if  you  wet  the  tube  and 
roll  it  in  powdered,  slippery  elm-bark,  instead  of  greasing  it,  pass  it 
slowly,  waiting  for  the  efforts  at  deglutition  its  passage  excites,  the 
operation  presents  no  difficulty.' 

It  would  seem  from  this  that  the  oesophagus-tube,  which  with 
English  practitioners  has  remained  in  the  experimental  stage,  has 
in  America  been  improved  on  to  the  extent  of  being  rendered 
a  useful  agent  in  affording  relief  in  both  gastric  tympany  and 
gastric  engorgement. 


CHAPTER  VIII 

RUPTURE  OF  THE  STOMACH  :  GASTRO 
RHEXIS 

Definition. — A  breach  or  disruption,  complete  or  in- 
complete, of  the  tunics  forming  the  walls  of  the  stomach, 
with  consequent  escape  of  the  contents  of  the  organ. 

Causes. — Principally  we  may  regard  this  lesion  as 
a  direct  result  of  the  disorder  considered  in  the 
previous  chapter,  the  mere  mechanical  pressure  of 
the  accumulated  gases  being  sufficient  to  bring  it 
about.  More  for  that  reason  than  that  it  offers  any 
particular  medical  problem  have  I  seen  fit  to  insert 
its  description  here.  Rupture  may  also  result  from 
ordinary  impacted  or  gorged  stomach  (Chapter  VI.), 
though  it  is  well  to  add  that  cases  following  upon 
that  condition  are  not  nearly  so  many  in  number 
as  those  succeeding  acute  gastric  tympany.  It  will 
naturally  follow  that  those  causes  enumerated  as  giving 
rise  to  tympanitic  stomach  might  be  again  stated  here  as 
indirect  factors  in  the  production  of  gastric  rupture, 
laying  special  stress  on  the  overfeeding  with  young 
green  stuffs,  and  the  excessive  use  of  boiled  or  steeped 
foods,  with  a  period  of  work  immediately  on  the  full 
stomach.  What  I  have  already  advised  under  that 
heading  will   bear   repeating   here :    *  Never   allow   the 


74  THE  COMMON  COLICS  OF  THE  HORSE 

horse  with  a  tympanitic  stomach  to  indulge  in  roUing.' 
There  can  be  no  doubt  whatever  that  the  violent  strains 
and  falls  the  frantic  animal  inflicts  upon  himself  when  in 
the  paroxysms  of  acute  gastric  tympany  are  directly 
accountable  for  many  of  our  cases  of  rupture. 

Cases  are  also  on  record  W'here  rupture  of  the  stomach 
has  been  accompanied  with,  and  no  doubt  preceded  by, 
a  thinned  and  ulcerated  condition  of  the  stomach  walls, 
occasioned  by  the  presence  of  large  numbers  of  bots 
{CEstvus  equi),  giving  rise,  in  the  first  place,  to  imperfect 
digestion  of  food,  with  its  concomitant  process  of  fermen- 
tation, resulting  in  tympany  and  pressure. 

Sometimes  a  sudden  heavy  fall  is  responsible  for  the 
lesion.  Mr.  Broad  instances  that  as  follows  :  '  An  aged 
horse,  in  a  very  weak  condition,  fell  while  at  work,  and 
was  with  difficulty  made  to  rise.  He  again  fell  on 
reaching  a  stable  close  by,  and  died  almost  imme- 
diately. The  coats  of  the  stomach  were  attenuated  and 
ruptured.'^ 

Other  and  rarer  causes  of  this  lesion  may  be  found  in 
the  atrophy  of  the  stomach  walls  produced  by  the  vice  of 
crib-biting,  or  in  the  ravages  produced  by  the  Spivoptcva 
megastoma.- 

I  shall  not  concern  myself  here  with  a  consideration  of 
the  nature  and  size  of  the  rupture,  nor  its  position  or 
pathological  appearances.  Our  interests  will  be  mainly 
confined  to  its  relation  to  colic,  and  the  way  in  which  it 
affects  our  diagnosis  of  the  various  disorders  we  are  dis- 
cussing. It  is,  therefore,  from  that  standpoint  that  I 
shall  conclude  this  chapter. 

Symptoms. — I  have  already  indicated  that  this  lesion 

^  Veterinary  Journal,  vol.  ii. ,  p.  178. 

2  Proceedings  of  the  Fifth  General  Meeting  of  the  National 
Veterinary  Association  (Smith). 


nUPTURE  OF  THE  STOMACH  75 

may  occur  with  the  stomach  wall  in  one  of  two  con- 
ditions. Either  the  tunics  are  in  a  state  of  health,  or 
they  are  suffering  from  the  ulcerated  and  atrophied 
condition  occasioned  by  the  inroads  of  parasites. 

We  may  take  it  from  this  that  when  the  stomach  walls 
are  weakened  by  previous  disease,  an  attack  of  simple 
colic  may  be  quite  sufficient  to  bring  about  the  rupture. 
In  the  paroxysms  of  pain  the  animal  flings  himself 
violently  to  the  ground,  and  the  mischief  is  done ;  in 
which  instance  the  case,  though  finally  diagnosed  as 
ruptured  stomach,  is  primarily  looked  upon  as  simple  in 
its  nature,  owing  to  the  regularly  intermittent  character 
of  the  pains.  It  is,  in  fact,  first  put  down  as,  what  it 
really  is,  a  simple  attack  of  colic,  the  rupture  occurring 
afterwards.  At  times  in  his  career  every  practitioner  is 
bound  to  make  that — I  was  almost  calling  it  '  mis- 
take.' He  knows  himself  that  it  was  a  correct  statement 
of  the  case  as  it  first  presented  itself  to  him.  When 
rupture  suddenly  changes  his  case  from  a  simple  to  a 
fatal  nature,  it  depends  entirely  upon  his  standing  with 
his  client  and  his  amount  of  ready  tact  whether  the 
veterinarian  retires  from  the  situation  in  ignominy  or 
emerges  therefrom  with  credit.  I  have  not  much  hesita- 
tion myself  in  declaring  this  to  be  one  of  the  rare  causes 
of  this  lesion.  Nevertheless,  it  occurs  with  sufficient 
frequency  to  confound  our  carefully-laid  prognosis  in 
other  cases. 

In  those  instances  where  the  rupture  is  primarily  pro- 
duced by  previous  enormous  tympany,  the  pains,  almost 
from  the  very  outset  of  the  case,  are  agonizing  and 
continuous. 

Our  case  of  ruptured  stomach,  then,  may  be  ushered 
in  with  either  intermittent  or  continuous  pain.  Once 
established,    however,   rupture    of    the    stomach    off'ers 


76  THE  COMMON  COLICS  OF  THE  HORSE 

symptoms     only     too     painfully     diagnostic     in     their 
character. 

Diagnosis.  — '  There  exist  two  cogent  reasons  for 
wishing  to  be  able  to  pronounce  at  once  upon  a  case  of 
ruptured  stomach  :  the  first  is,  the  preservation,  if  not 
enhancement,  of  the  medical  attendant's  reputation  ;  the 
second,  the  saving  of  solicitude  on  his  part,  and  the 
annoyance  on  the  part  of  his  patient,  of  administering 
anything  under  such  hopeless  circumstances.' ^ 

Difficult  to  describe,  it  is  the  character  of  the  pulse 
that  gives  the  experienced  veterinarian  his  first  warning 
of  the  fatal  nature  of  his  case.  During  the  early  stages — 
that  is,  before  rupture  has  occurred — the  pulse  is  full  and 
firm  in  its  beats  ;  contracted  to  a  thread  only  during  the 
paroxysms  of  colic ;  again  becoming  full  and  bounding 
in  the  intervals  of  comparative  ease.  With  the  appear- 
ance of  rupture  its  whole  character  is  altered,  and  it  grows 
small,  frightfully  quick,  and  as  frequent  as  90  to  120.  I 
cannot  better  describe  '  small '  than  by  saying  it  is  that 
kind  of  pulse  the  novice  has  difficulty  in  detecting  at 
all — the  vessel  is  not  fully  distended.  The  respirations 
become  accelerated,  and  the  conjunctiva  slightly  injected. 
The  pains  increase  in  violence,  and  the  patient  becomes 
almost  ungovernable.  Later,  the  unfortunate  animal  is 
bathed  in  sweat,  trickling  in  drops  down  the  face,  running 
down  the  mane,  coursing  in  streams  down  the  inside  of 
the  arms  and  thighs,  and  splashing  in  drops  from  the 
belly.  Violent  tremors  shake  the  body,  the  tail  is  out- 
stretched and  quivering,  and  the  extremities  are  deathly 
cold.  The  hand  that  takes  the  pulse  in  the  brachial 
region  is  withdrawn  with  a  shudder  ;  the  signs  conveyed 
to  it  lead  to  an  almost  instinctive  dread,  a  significant 
intuition  of  fast  coming  dissolution. 

*  Percivall's  '  Ilippopathology,'  vol.  ii.,  p.  24. 


RUPTURE  OF  THE  STOMACH  77 

The  patient  may  now  sit  for  several  minutes  at  a  time 
on  his  haunches,  or,  as  is  more  general,  may  stand 
quietly,  giving  the  uninitiated  the  appearance  of  greater 
ease.  His  countenance,  however,  is  still  indicative  of 
his  condition.  It  is  almost  *  sardonic  '  in  the  expression 
it  conveys.  The  ears  droop,  the  angles  of  the  mouth  are 
retracted,  and  the  teeth  protrude  in  a  ghastly  grin. 

It  is  now  that  the  vomiting  —  the  much -discussed 
vomiting — begins  to  occur.  Every  now  and  again  the 
fluid-like  ingesta  of  the  stomach  is  ejected  with  or  with- 
out symptoms  of  vomiting  on  the  part  of  the  patient,  and 
the  administration  of  medicines  only  tends  to  aggravate 
his  suffering.  In  some  cases  the  emesis  is  but  an  in- 
voluntary, though  constant,  dribble  from  the  nostrils  ; 
in  others  it  is  an  act  of  distinct  and  painful  retching, 
accompanied  with  all  the  equine  phenomena  of  vomiting. 
One  other  symptom  there  is  which,  if  only  constant, 
would  lead  to  diagnosis  always  being  absolute.  I  refer 
to  the  escaped  ingesta  being  detected  in  the  peritoneal 
cavity  when  exploring  per  rectum.  It  is  unfortunate 
that  this  evidence  is  not  constantly  obtainable. 

The  pulse  now  becomes  more  and  more  imperceptible, 
the  muscular  tremors  increase  in  severity,  the  breathing  is 
a  shivering  sob,  and  the  legs  are  propped  out  wide  apart 
to  keep  the  unfortunate  animal  from  falling.  When  he 
drops  it  is  all  over,  for  a  very  few  seconds  then  ends  the 
scene,  and  the  poor  brute  usually  expires  with  the  ingesta 
gushing  in  streams  through  his  nostrils. 

These  symptoms  are  the  ones  that  may  fairly  be  taken 
as  diagnostic — that  is,  as  far  as  we  are  able  to  diagnose 
this  affection.  They  will  lead  to  a  correct  diagnosis  in 
the  majority  of  instances.  In  addition  to  the  signs  here 
given,  however,  the  young  practitioner  must  remember 
that  all  the  usual  symptoms  of  '  colic,'  as  described  in 


78  THE  COMMON  COLICS  OF  THE  HORSE 

other  chapters  (Tympanitic  Stomach,  for  instance),  may 
be  shown  in  gastric  rupture. 

The  reader  will  have  gathered  from  the  foregoing  that 
we  have  no  really  diagnostic  symptoms  of  ruptured 
stomach.  General  F.  Smith  sums  the  matter  up  thus : 
*  Diagnosis  of  this  affection  is  anything  but  easy ;  we 
have  no  diagnostic  symptoms,  and  no  two  cases  of  this  lesion 
present  the  same  appearances.  I  think  the  symptoms 
on  which  we  can  place  the  most  reliance  are  :  paroxysms 
after  the  administration  of  medicines,  extreme  anxiety  of 
countenance,  in  some  cases  the  presence  of  particles  of 
ingesta  in  the  peritoneal  sac  detectable  on  exploration 
per  rectum,  running  down  pulse,  cold  sweats  and  rigors, 
with  coldness  of  the  surface  ;  and  should  vomiting  and 
sitting  on  the  haunches  occur  in  conjunction  with  these, 
it  only  strengthens  the  diagnosis,  but  their  absence  in  no 
wise  weakens  it.' 

Prognosis. — Once  positively  diagnosed,  the  case,  of 
course,  is  hopeless.  The  question  the  veterinarian  is 
most  likely  to  ask,  however,  is  this  :  *  What  dependence 
am  I  to  place  on  the  symptom  of  vomiting  ?  When 
vomiting  occurs,  am  I  to  positively  declare  my  case  one 
of  rupture?'  Owing  to  this  vomiting  question  being  a 
much  vexed  one,  several  facts  stand  out  with  greater 
distinctness  than  they  otherwise  would  have  done.  For 
instance,  it  is  certain — 

1.  That  cases  of  rupture  occur  in  which  vomiting  is  a 
most  marked  symptom. 

2.  That  cases  of  rupture  occur  in  which  vomition  is 
altogether  absent. 

3.  That  cases  of  vomiting  occur,  followed  by  speedy 
recovery,  from  which  we  may  reasonably  infer  that 
there  was  no  rupture. 

It  follows  from  this    that   vomition  is  not  absolutely 


RUPTURE  OF  THE  STOMACH  79 

diagnostic  of  rupture.  It  is  only  fair  to  add,  however, 
that  it  is  so  frequently  an  accompaniment  of  that  lesion 
as  to  render  it  of  great  value  when  summing  up  our  case. 
Even  when  vomiting  is  present  in  alarming  degree,  it  is 
the  veterinary  surgeon's  duty  to  persist  in  treating  his 
case  for  gastric  engorgement,  gastric  tympany,  or 
whatever  he  may  have  decided  it  is,  reserving  all  his 
statements  by  saying  '  that  it  is  just  possible  rupture 
may  occur,'  and  declining  to  advise  his  client  of  the 
advent  of  rupture  until  all  or  most  of  its  absolutely  fatal 
signs  are  present.  Taken  singly,  there  are  no  diagnostic 
symptoms  of  ruptured  stomach.  Collectively,  however, 
the  evidence  obtained  from  the  patient  should,  in  most 
cases,  allow  of  a  prognosis  being  given.  Needless  to 
say,  it  is  a  fatal  one. 

Treatment. — Beyond  prophylaxis,  the  treatment  of 
ruptured  stomach  is  out  of  all  question.  Means  for  its 
prevention,  however,  may  be  discussed  with  advantage. 
Nevertheless,  it  is  not  my  intention  to  enlarge  on  them 
here.  They  are  so  largely  dependent  on  common-sense 
reasoning,  deduced  from  the  causes  of  other  stomach 
troubles,  that  it  would  be  but  tedious  repetition  on  my 
part  to  mention  them  in  detail  again. 

We  may  take  it  that  the  reader  of  this  volume  will 
gather  sufficient  information  from  the  chapters  on  The 
Predisposing  Causes  of  Colic,  Gastric  Impaction,  and 
Gastric  Tympany  to  enable  him  to  appropriately  point 
out  the  suitable  preventive  measures  likely  to  guard 
against  the  occurrence  of  this  most  distressing  and  fatal 
lesion. 


CHAPTER  IX 

SUBACUTE  OBSTRUCTION  OF  THE 
DOUBLE  COLON  :  IMPACTION  OF 
THE  INTESTINES,  IMPACTION  OF 
THE  COLON,  STOPPAGE  OF  THE 
BOWELS 

Definition.  —  Intestinal  impaction  or  obstruction,  if 
loosely  used,  is  a  term  which  will  cover  a  multitude  of 
widely  differing  disorders,  and  I  cannot  help  but  think 
that  the  time  is  now  ripe  for  an  attempt  to  separate 
a  few  of  them  from  their  confusing  surroundings,  and 
essay  to  consider  them  singly.  I  am  not  without  hope 
that  in  so  doing  a  more  dependable  knowledge  of  their 
peculiarities  will  be  gathered — a  knowledge  which  must 
inevitably  lead  to  a  more  correct  diagnosis,  and  a  cor- 
responding improvement  in  the  particular  line  of  treat- 
ment adopted  for  each.  To  further  that  end  I  have, 
somewhat  arbitrarily,  I  admit,  and  yet  not  without  a  due 
amount  of  just  reason  for  so  doing,  divided  the  subacute 
intestinal  obstructions  into  four  separate  and  distinct 
forms — viz.,  subacute  obstruction  of  the  small  intestine, 
subacute  obstruction  of  the  double  colon  considered 
generally  and  without  regard  to  special  position,  sub- 
acute obstruction  of  the  pelvic  flexure  of  the  double 
colon,  and  subacute  obstruction  of  the  single  colon. 

Taking   the   three    forms    of  intestinal  obstruction   I 
have    mentioned    in     their    correct    anatomical    order, 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON    8i 

« subacute  obstruction  of  the  small  intestine '  should 
properly  have  been  described  first.  I  have  my  reasons, 
however,  for  giving  this  general  obstruction  of  the  double 
colon  prior  place.  Among  them  is  the  fact  that  it  is  this 
particular  variety  that  occurs  most  often  in  practice,  and 
has  led  to  the  terms  '  impaction  of  the  bowels '  and 
*  stoppage  of  the  bowels  '  being  so  loosely  applied  to  other 
and  distinct  types.  The  word  '  subacute  '  is  purposely 
inserted  in  order  to  exclude  such  acute  occlusions  of  the 
bowels  as  partial  or  complete  twist,  strangulated  hernia, 
intussusception,  etc.  That  being  done,  we  are  compelled 
to  a  consideration  of  such  disorders  as  are  brought  about 
by  any  circumstance  that  causes  a  stationary  or  torpid 
condition  of  the  bowels,  or  the  surcharging  of  the  intestinal 
tract  with  bulky,  indigestible  food. 

The  present  chapter,  then,  is  given  over  to  the  descrip- 
tion of  all  obstructions  of  a  subacute  type  that  occur  in 
any  position  in  the  large  or  double  colon,  with  which, 
until  differential  means  of  diagnosis  present  themselves, 
I  include  typhlitic  or  caecal  impaction. 

Before  coming  to  its  actual  description,  it  will  be 
necessary  to  continue  this  definition  further.  A  reference 
to  Professor  Friedberger's  table  in  Chapter  I.  shows 
plainly  enough  that  it  comes  under  the  second  division  of 
the  essential  form  of  true  colic — i.e.,  colic  consequent  upon 
anomalies  of  the  intestinal  contents.  The  question,  then, 
arises.  Will  it  be  {a)  the  colic  produced  by  overfeeding, 
or  {h)  the  colic  occasioned  by  stoppage  in  the  intestinal 
canal  ?  In  my  opinion,  the  definitions  thus  indicated 
are,  to  a  very  great  extent,  interchangeable,  for  in  the 
colic  I  am  about  to  describe  (that  occasioned  by  stoppage 
in  the  intestinal  canal,  known  commonly  as  impac- 
tion of  the  intestines)  there  can  be  no  doubt  that  over- 
feeding is  responsible  for  a  great  majority  of  the  cases. 


82  THE  COMMON  COLICS  OF  THE  HORSE 

There  may  or  may  not  be  colic  pains  with  the  over- 
feeding, and  yet  the  overcharging  of  the  horse's  intestines 
may  give  rise  to  impaction,  or  stoppage — faecal  accumula- 
tion. To  make  myself  plainer,  we  may  have  overfeeding 
and  yet  no  symptom  of  colic,  until  it  has  become  really 
a  case  of  impaction  or  stoppage.  That  is  really  what 
always  occurs  in  the  great  majority  of  cases  of  so-called 
impaction  of  the  intestines,  the  only  premonitory 
symptoms  (prior  to  constipation  or  stoppage)  being  dul- 
ness.     No  exhibition  of  abdominal  pain  whatever. 

Then,  again,  take  (b),  or  the  colic  brought  on  by 
flatulence.  Here,  also,  it  is  evident  that  it  may  arise 
merely  as  a  result  either  of  overfeeding  or  of  obstruction. 
So  that,  to  sum  up,  w^e  may  say :  '  The  (a)  form  of  colic — 
viz.,  that  produced  by  overfeeding—  may  or  may  not  be 
accompanied  by  flatulence,  and  may  or  may  not  be  pro- 
ductive of  obstruction,  again  with  or  without  flatulence.' 
That  is  what  one  really  sees  if  notes  are  taken  of  a  series 
of  cases,  and  I  will  endeavour  to  make  my  statement 
still  clearer  directly.  I  do  not  wish  to  convey  that  there 
is  no  such  thing  as  a  pure  type  of  flatulent  colic  ;  in  fact, 
Chapter  XV.  is  solely  reserved  for  its  consideration.  I 
merely  wish  to  point  out  that  in  a  great  many  cases  the 
flatulence  is  solely  dependent  on  previous  conditions  that 
are  in  themselves  another  and  distinct  variety  of  colic. 

Causes. — For  these  I  must  again  ask  the  reader  to 
refer  largely  to  Chapters  IV.  and  V.  He  will  find 
there  an  enumeration  of  such  general  predisposing  and 
exciting  causes  of  colic  as  will  render  my  work  in  this 
particular  section  very  short.  I  w^ould,  however,  ask 
him  to  particularly  remember  what  I  have  written  re- 
garding the  anatomical  reasons  for  expecting  the  horse 
to  be  peculiarly  liable  to  attacks  of  '  colic  ' :  the  small 
size  of  his  stomach,  the  great  length  and  complicated 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON     83 

distribution  of  his  intestines,  together  with  their  com- 
paratively fragile  structure  and  the  enormous  loads  they 
are  called  upon  to  carry,  and  the  natural  bars  to  vomition. 
His  judgment  should  also  be  guided  by  a  due  considera- 
tion of  such  physiological  reasons  as  the  short  length  of 
time  the  food  requires  to  remain  in  the  digestive  tract, 
the  matter  of  age  and  defective  teeth,  hereditary  predis- 
position, and  the  question  of  temperament.  I  would  also 
enjoin  on  him  not  to  forget  the  effects  of  change  of 
climate,  all  those  little  errors  resultant  on  the  horse's 
domestication  :  the  matter  of  correct  feeding  and  proper 
watering,  the  length  of  his  hours  of  work  and  rest,  and 
the  number  of  times  he  is  fed  in  the  day.  Among  all 
these  will  be  found  numberless  causes  of  obstructive 
colic.  More  particularly  still  would  I  request  him  to 
bear  in  mind  such  causes  as  the  collection  of  sandy  or 
gravelly  deposits  in  the  colon  from  the  ingestion  of  fodder 
so  contaminated,  the  weakening  and  lowering  of  tone  of 
the  intestinal  muscles  consequent  on  debilitating  diseases, 
aneurismal  interference  with  the  blood-supply  to  various 
portions  of  the  digestive  tube,  and  the  presence  of  the 
foetus  in  animals  heavy  with  foal. 

Of  these  and  others  fuller  details  will  be  found  in  the 
chapters  mentioned.  All  are  likely,  in  their  turn,  to  have 
a  preponderating  influence  in  determining  an  attack  of 
*  intestinal  obstruction.'  Nevertheless,  we  may  correctly 
sum  up  by  declaring  that  a  very  great  majority  of  the 
causes  of  intestinal  impaction  are  directly  referable  to 
errors  in  diet. 

Symptoms. — These  will  be  found  to  vary,  in  greater 
or  less  degree,  in  nearly  every  case  the  veterinary  surgeon 
is  called  upon  to  attend.  Before  proceeding,  however,  it 
will  be  wise  to  remind  the  reader  that  I  am  not  dealing 
with   acute   intestinal    obstruction    (under   which    head 

6—2 


84  THE  COMMON  COLICS  OF  THE  HORSE 

would  come  partial  or  complete  twist  of  the  bowels,  etc.). 
In  those  cases  the  character  of  the  pain  is  acute  and 
agonizingly  persistent,  and  the  disease  runs  a  rapid  and 
fatal  course  of  from  twelve  to  twenty-four  hours.  I  have 
made  a  second  notice  of  the  acute  disorder  here  in  order 
to  firmly  impress  on  the  mind  of  the  veterinarian  that  it 
will  be  absolutely  necessary  for  him  to  negative  the  idea 
of  his  case  being  of  that  description  before  a  suitable  and 
proper  treatment  can  be  adopted.  I  do  not  imagine  for 
one  moment  that  this  conclusion  may  be  arrived  at  by  a 
hasty  and  half-hearted  examination  of  our  patient ;  for, 
as  a  perusal  of  the  table  of  cases  at  the  end  of  this 
chapter  will  show,  we  may  be  deceived  by  the  symptoms, 
the  pulse,  the  temperature,  or  the  respirations,  or  we  may 
be  misled  by  all  combined,  if  our  examination  be  not  a 
lengthy  and  a  searching  one. 

Didl  Subjective  Symptoms. — The  symptoms  of  a  sub- 
acute attack  will  be  in  main  what  are  nearly  always,  and 
I  think  correctly,  described  by  practitioners  as  '  dull 
pains.'  They  are  so  plainly  of  a  dull  character  as  to 
lead  the  owner  to  treat  the  case  lightly  and  to  neglect 
sending  for  assistance  at  the  outset.  Frequently  he 
allows  twelve  or  even  twenty- four  hours  to  elapse  before 
sending  for  skilled  advice.  The  animal  is  dull  and  list- 
less, perhaps  refuses  his  food,  or  picks  a  httle  now  and 
again.  At  this  stage  the  pulse,  temperature,  and  respira- 
tions are  but  little  altered.  These,  however,  change  as 
time  goes  on,  and  the  animal  begins  to  show  signs  of  un- 
easiness and  pain,  such  as  walking  round  the  box,  and 
smelling  at  the  bedding.  Otherwise  he  leans  heavily  with 
his  hind-quarters  against  the  nearest  post  or  wall,  with  an 
occasional  pawing  movement  of  the  fore-limbs  or  an 
irritant  stamp  of  the  hind.  Perhaps  the  animal  even 
ventures  to  lie  down,  and,  if  so,  only  after  repeated  and 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON     85 

careful  crouching  movements.  As  he  stretches  himself 
out,  he  emits  a  long-drawn  sigh,  or  a  slight  but  lengthy 
groan,  and  then  Hes  out  at  full  length,  for,  it  may  be,  an 
hour  at  a  time.  While  down,  his  pain  is  manifested  by 
his  occasionally  bringing  the  head  round  to  the  side,  and 
looking  with  anxious  and  troubled  countenance  towards 
his  flank.  Also,  the  breath  is  held  after  the  act  of  in- 
spiration, and  retained  until  the  voluntary  muscle  is 
overcome  by  the  deoxygenated  state  of  the  blood  in  the 
vessels  of  the  brain.  After  lying  for  some  time,  he  will 
get  up  and  exhibit  the  same  set  of  symptoms  again  from 
beginning  to  end. 

Dull  Objective  Symptoms. — Examination  per  rectum  will 
generally  show  that  bowel  to  be  empty,  or  containing  at 
the  most  a  few  small,  hard,  and  mucous-covered  lumps. 
The  bowel  is  sometimes,  though  not  always,  what  is 
termed  '  ballooned,'  and  we  may  or  may  not  notice  violent 
straining  and  attempts  on  the  part  of  the  animal  at  de- 
faecation.  It  may  be,  however,  in  some  cases  that  the 
rectum  is  not  empty,  but  full,  to  a  state  of  impaction, 
with  material  varying  from  a  semi-fluid  to  a  solid  con- 
sistence. The  bladder  is  usually  empty,  and  nearly 
always  other  portions  of  the  intestines  can  be  felt  crammed 
to  their  full  with  impacted  faecal  matter.  Ascultation  of 
the  abdominal  walls  reveals  not  the  slightest  sign  of  peri- 
stalsis. Sometimes  there  is  an  accompanying  slight  tym- 
pany, and  during  auscultation  we  may  then  hear  a  peculiar 
metallic  tinkle,  caused  by  some  feeble  attempt  of  the  bowel 
at  peristalsis.  Contrary  to  many,  I  attach  no  grave  im- 
portance to  that  sound — rather  the  reverse.  The  ex- 
tremities are  cold,  and  the  mouth  clammy  and  foetid. 
When  hereafter  I  allude  to  '  dull '  pains,  I  am  referring  to 
the  symptoms  described  above.  Often,  however,  we  may 
have  symptoms  much  more  violent  and  alarming. 


86  THE  COMMON  COLICS  OF  THE  HORSE 

Acute  Subjective  and  Objective  Symptoms  in  Subacute 
Colic. —  It  will  appear  odd,  I  confess,  to  talk  of  the  oc- 
currence of  acute  symptoms  in  subacute  colic,  and  yet 
we  must  be  prepared  to  admit  that  the  frequent  and 
rapid  recovery  of  animals  showing  acute  symptoms  suf- 
ficiently negatives  the  idea  of  their  ailment  being  of  such 
an  acute  variety  as  twist,  etc.  Without  attempting  to 
argue  that  spontaneous  recovery  from  twist,  or  other 
serious  condition,  is  impossible,  we  may,  with  every 
regard  for  logic,  allow  that  symptoms  of  an  acute  nature 
may  be  observed  in  subacute  colic.  The  pain  becomes 
much  more  violent.  The  animal  walks  round  and  round 
his  box.  The  ears  and  extremities  grow  deathly  cold. 
Cold,  patchy  perspirations  bedew  the  underneath  surface 
of  the  abdomen,  and  break  out  between  the  forearms  and 
thighs,  while  the  expression  becomes  anxious  to  an 
alarming  degree.  Tympany  becomes  much  more  notice- 
able ;  the  animal  reels  in  his  walk,  and  casts  himself 
down  with  such  violence  as  to  almost  resemble  a  fall. 
The  pulse  is  increased  in  frequency,  and  is  not  so  full  to 
the  fingers.  The  visible  mucous  membranes  become  in- 
jected, and  appear  of  a  deep  red  hue.  Frequently,  too, 
in  this  special  form  of  colic,  the  membranes  are  tinged 
with  yellow,  reminding  one  of  the  early  stages  of  jaundice. 

Such  are  the  usual  symptoms  of  intestinal  impaction, 
and  their  average  duration  may  be  anything  from  twelve 
or  fifteen  to  twenty-four  hours.  The  longest  period  that 
I  myself  remember  an  animal  suffering,  and  ultimately 
recovering,  is  eight  days.  In  fatal  cases  forty-eight 
to  thirty-six  hours  usually  sees  the  end. 

Diagnosis. — I  am  fully  persuaded  that  this  is  the 
most  easily  diagnosed  of  all- our  cases  of  colic,  and  con- 
cerning it  a  mistake  ought  seldom  or  never  to  be  made. 
Such  a  thing,  however,  as  a  diagnostic  symptom  is  not 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON     87 

to  be  looked  for.  It  is  only  by  a  complete  and  orderly 
analysis  of  the  whole  of  the  history,  and  by  a  proper 
weighing  up  of  all  the  signs,  that  a  correct  diagnosis  can 
be  arrived  at.  Nevertheless,  upon  one  fact  I  wish  to 
place  the  greatest  possible  emphasis.  The  value  of 
taking  the  indications  of  the  pulse,  temperature,  and 
respirations  collectively,  in  order  to  avoid  error  in  prog- 
nosis, cannot  be  overestimated.  I  never  look  upon 
a  case  as  approaching  dangerous  unless  I  get  a  full 
warning  from  all  three.  A  reference  to  Case  No.  7,  at 
the  end  of  this  chapter,  will  explain  what  I  mean.  Here 
was  an  animal  which  had  been  rolling  in  violent  pain 
before  my  arrival,  but  was  now  standing  perfectly  quiet. 
An  alarming  state  of  the  pulse  was  evident,  hammering 
away  at  the  rate  of  108  to  the  minute.  The  temperature, 
however,  was  only  101°  F.,  and  the  number  of  respira- 
tions 12.     The  animal  recovered. 

Take,  again,  Case  No.  6.  The  respirations  here  were  a 
continual  sob  of  32  to  the  minute,  and  the  horse  was  in  a 
bath  of  perspiration  for  over  an  hour.  The  pulse  was  only 
48,  and  the  temperature  101-4°  F.    The  animal  recovered. 

Or  take  Case  No.  3.  The  temperature,  96*6°  F.  (which 
may  be  taken  as  subnormal  in  shire  horses),  was  counter- 
balanced by  the  pulse  (48)  and  the  respirations  (13). 
This  animal  also,  after  a  lengthy  illness,  recovered. 

Here  I  will  take  the  opportunity  of  stating  that  I 
believe  it  to  be  absolutely  impossible  to  diagnose 
*  straight  away  '  even  this,  the  most  easily  diagnosed  and 
best  understood  of  all  our  cases  of  colic.  No  committing 
statement  ought  to  be  made  and  no  large  amount  of 
drugs  exhibited  until  the  case  has  been  closely  watched 
for  some  time.  For  example,  witness  Case  No.  13. 
Judging  from  my  foregoing  remarks,  the  irregularity  of 
the   respirations    and    temperature    in    this   case  should 


88  THE  COMMON  COLICS  OF  THE  HORSE 

certainly  have  merited  a  bad  prognosis.  Still,  I  was 
tempted  to  hold  out  hopes,  for  the  reason  that  we  had  a 
perfectly  normal  pulse — normal  in  tone  and  normal  in 
number.  The  conclusion  of  that  case  alone  warrants  me 
in  giving  the  advice  to  take  the  pulse,  temperature,  and 
respirations  collectively,  for  an  hour  later  saw  the 
character  of  the  pulse  enormously  changed  for  the  worse. 
I  was  compelled  to  give  a  fatal  prognosis,  and  the  animal 
died  nine  hours  afterwards.  The  attentive  reader  will 
notice  that  this  case  was  really  one  of  acute  gastric 
tympany.  It  was,  however,  inserted  with  this  list  of 
cases  of  obstruction  to  illustrate  more  forcibly  the 
remarks  I  have  just  made.  This  special  attention  paid 
to  the  character  of  the  pulse  in  conjunction  with  the 
temperature  and  respirations,  the  symptoms  I  have  given 
well  weighed,  and  his  own  powers  of  observation  brought 
well  into  play,  should  leave  the  veterinarian  in  a  fair  way 
to  satisfactorily  come  to  a  right  conclusion. 

Prognosis. — The  subacute  obstructive  colics  are  the 
ones  among  these  many  disorders  that  allow  the  veteri- 
narian ample  time  in  which  to  judge  pretty  accurately  of 
the  probable  termination  of  the  attack. 

Having  diagnosed  his  case,  and  ascertained  that  he  has 
a  fairly  normal  pulse,  he  may,  with  every  confidence,  rely 
upon  the  great  majority  of  his  patients  recovering,  if  not 
too  seriously  hampered  by  the  administration  of  unsuit- 
able drugs.  He  should  in  most  instances  carefully 
explain  the  nature  of  the  complaint  to  the  owner ;  point 
out  the  fact  that  the  condition  of  the  pulse  is  such  as  to 
occasion  him  no  alarm ;  advise  him  that  an  alteration  in 
the  pulse  will  be  the  first  sign  of  a  likely  fatal  conclusion  ; 
and  pledge  himself  to  immediately  warn  his  client  should 
such  alteration  unfortunately  occur.  So  long  as  the 
pulse  remains  good,  the  patient's  strength  is  maintained. 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON     89 

and  his  system  responds  readily  to  the  action  of 
stimulants,  so  long  may  a  favourable  prognosis  be  in- 
dulged in,  and  the  medical  attendant  need  not  necessarily 
be  alarmed  at  the  continuance  of  pains  spread  over  a 
period  of  three  or  four  days.  In  fact,  the  comparative 
cessation  of  pains,  if  unaccompanied  by  an  action  of  the 
bowels,  may  sooner  be  regarded  as  an  unfavourable  sign. 
The  time  at  which  the  circumstances  look  their  blackest, 
when  the  pains  are  most  severe,  and  the  uninitiated 
lookers-on  the  most  anxious,  is  often  the  turning-point  in 
the  case,  and  it  is  at  such  moments  that  I  would  carefully 
caution  the  worried  veterinarian  to  rigorously  hold  him- 
self in  check,  and  arbitrarily  abstain  from  the  exhibition 
of  sedatives.  Could  he  but  bring  himself  to  do  so  in  a  few 
successive  cases,  he  would  soon  come  to  look  upon  the 
pain,  distressing  to  witness  no  doubt,  as  only  a  necessary 
factor  towards  a  complete  and  rapid  resolution,  and  would 
be  able,  even  in  that  anxious  time,  to  hold  out  to  the 
solicitous  owner  still  further  hopes  of  a  near  recovery. 

Treatment. — My  ideas  concerning  this  are  somewhat 
unorthodox.  I  cannot,  therefore,  detail  my  own  without 
first  giving  that  more  generally  practised.  Probably  the 
most  common  of  all  is  the  administration  of  an  aloetic 
ball,  the  dose  varying  from  6  to  7  or  8  drachms,  according 
to  the  size  and  age  of  the  animal.  Those  who  follow 
this  usually  administer  at  the  same  time  antispasmodics 
and  anodynes.  Others  there  are  who  discard  the  aloes> 
and  rely  simply  upon  the  exhibition  of  the  anodynes. 

For  the  aloes  it  is  said  that  the  colic  in  this  case  is 
due  to  a  collection  of  irritating  food  in  the  intestine,  and 
that  the  rational  treatment  is  the  administration  of  a 
purgative  to  remove  the  offending  substance. 

The  antispasmodics  and  anodynes  are  exhibited 
for  the  relief  of  spasm.     Those  who  so  treat  their  cases 


90  THE  COMMON  COLICS  OF  THE  HORSE 

appear  to  regard  spasm  as  a  condition  standing  alone. 
Percivall  even  goes  so  far  as  to  describe  finding  spasmed 
portions  of  bowel  after  death.  He  says :  '  The  seat  of 
spasm,  in  common,  is  the  small  intestines ;  in  particular, 
the  jejunum  and  ileum.  I  have  seen  the  duodenum, 
however,  contracted  as  well ;  in  one  case,  a  few  inches 
from  the  stomach,  its  canal  appeared  to  be  perfectly  im- 
passable. I  have  also,  in  three  or  four  instances,  met 
with  it  in  the  large  guts ;  in  one  all  three  of  them 
exhibited  evident  marks  of  spasm ;  the  caecum  was 
exceedingly  distorted  by  contraction  ;  .  .  .  even  the 
rectum  had  manifestly  been  spasmed.' 

If  spasm,  as  spasm  only,  is  what  we  are  to  treat  in 
these  cases,  then  the  exhibition  of  a  suitable  anodyne  is 
doubtless  the  most  correct  treatment.  Nothing  more 
need  be  given.  Opium  in  the  crude,  as  a  watery  decoc- 
tion, or  in  the  form  of  a  tincture,  was  usually  resorted  to. 
Modern  treatment,  however,  calls  for  the  administration 
of  morphia,  or  morphia  and  atropine,  hypodermically. 
Extract  of  cannabis  indica,  too,  has  crept  to  the  front  a 
great  deal  during  the  last  few  years.  It  is  said  not  to 
derange  the  stomach  and  intestines  to  the  extent  that 
opium  does  ;  that  it  relieves  spasm  and  pain  as  quickly 
and  more  permanently,  and  without  arresting  the  action 
of  the  bowels.  Chloral  hydrate,  also,  is  a  favourite  drug 
with  those  who  adopt  this  treatment. 

Even  when  the  more  simple  explanation  of  uncom- 
plicated spasm  is  denied,  and  the  case  admitted  to  be  one 
of  obstruction,  practitioners  still  continue  the  adminis- 
tration of  sedatives  or  anodynes  for  a  different  reason. 
'  It  is  the  pain,'  they  say, '  that  will  wear  the  animal  out.' 
We  are  not,  therefore,  to  administer  a  purgative,  and 
simply  wait  for  its  operation.  We  must  at  the  same 
time    alleviate    the    animal's     sufferings.      Those   who 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON     91 

follow  this   line  of  reasoning  will,  therefore,  administer 
some  such  remedy  as  Percivall's  : 

Aloes  sol. gxii. 

Tr.  opii  I  _-,-.. 

Spts.  eth.  nit.  j      '         "         "         '  ^a  311. 

Aq.  fervens  .         -         .         -  Oss. 

Mi  see  ;  fiat  hau",t. 

In  the  treatment  of  to-day  that  would  resolve  itself 
into  the  administration  of  a  7-drachm  ball  of  aloes,  6  to 
8  grains  of  morphia  hypodermically,  and  about  2  ounces 
of  spts.  eth.  nit.,  in  a  drench. 

In  addition  to  the  administration  of  sedatives  alone,  or 
combined  aloes  and  anodynes,  enemas  are  frequently 
thrown  into  the  rectum.  Many  also  advocate  the  use 
of  hot  fomentations  to  the  belly,  in  order  to  promote 
peristalsis.  So  long  as  the  case  lingers  on,  the  exhibition 
of  sedatives  in  decreasing  doses  is  persisted  in  ;  and  if 
the  practitioner  be  particularly  bold,  the  aloes  is  supple- 
mented by  a  dose  of  linseed-oil.  It  is  common,  also,  to 
find  oil  of  turpentine  administered  to  prevent  the  rise  of 
fermentation  and  tympany. 

It  cannot  be  gainsaid  that  the  above  line  of  treatment 
is  successful.  At  any  rate,  it  has  been  continuously 
adopted  by  a  large  number  of  practitioners  for  a  great 
many  years.  If  anything  new  is  to  be  introduced,  it 
must  show  advantage  over  the  old.  Whether  or  no 
the  treatment  I  am  about  to  advocate  will  do  that  can 
only  be  judged  from  experience.  For  my  own  part, 
it  has  caused  me  to  entirely  cast  aside  the  aloes  and 
anodynes  in  its  favour.  Several  years'  experience  of 
a  solely  stimulative  treatment  has  led  me  to  believe 
it  a  great  deal  more  rational  than  either  of  those  de- 
scribed, and  certainly  more  successful.  I  have  also  found 
it  wise  to  refrain  from  using  aloes.  A  treatment  based 
upon  these  lines  I  shall,  therefore,  next  describe. 


92  THE  COMMON  COLICS  OF  THE  HORSE 

The  Stimulant  Treatment. — When  first  I  came  to 
rely  mainly  upon  stimulants  in  the  treatment  of  equine 
colic,  I  naturally  turned  to  what  literature  I  had,  in 
order  to  see  how  far  I  was  justified  in  so  doing.  This 
surprised  me.  Having  properly  and  correctly  diagnosed 
a  disease,  I  used  to  think  that  its  treatment  would  follow 
naturally.  A  long  plodding  through  the  annals  and 
records  of  veterinary  medicine  has  shown  me,  however, 
that  such  is  not  the  case  with  this  particular  disorder. 
In  no  single  disease,  I  should  imagine,  have  so  many  and 
widely  differing  drugs  been  given.  From  the  most  potent 
sedatives  we  know  of  to  the  most  drastic  purge  or  power- 
ful stimulant  the  Pharmacopoeia  possesses,  they  have  all 
been  given.  Not  only  have  they  been  given  in  the 
treatment  of  like  disorders  in  different  patients  ;  they 
have  been  indiscriminately  mixed  in  single  cases. 

Now,  I  do  not  believe  in  giving  purgatives  and 
stimulants  with  one  hand  and  administering  sedatives 
with  the  other.  Above  all  things,  whether  the  occasion 
demands  the  exhibition  of  aloes,  the  administration  of 
stimulants,  or  the  injection  of  morphia  and  atropine, 
let  us  abide  by  the  one  treatment  we  have  decided  the 
case  merits. 

So  far  as  we  have  gone,  our  summing-up  stands  thus : 
In  the  treatment  of  subacute  intestinal  impaction  many 
practitioners  rely  wholly  upon  sedatives ;  others  always 
combine  the  sedatives  or  anodynes  with  aloes ;  while  a 
few  advocate  the  use  of  stimulants.  So  long  as  matters 
remain  so,  a  description  of  any  particular  treatment  of  this 
disorder  should  be  accompanied  with  fairly  sound  reasons 
for  its  recommendation.  I  have  therefore  made  the  few 
following  pages  as  argumentative  as  possible.  Without 
wishing  to  disturb  the  routine  of  those  who  have  for 
many  years  practised  a  particular  method  with  a  reason- 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON     93 

able  amount  of  success — a  method  which,  perhaps,  the 
need  of  their  district  calls  for — I  would  still  wish  to 
appeal  strongly  to  those  who  are  yet  wavering. 

To  commence  with,  provided  we  have  diagnosed  our 
case,  and  are  certain  that  we  have  purely  a  condition  of 
subacute  intestinal  obstruction  to  deal  with,  we  cannot 
do  better  than  ask  ourselves  the  following  questions : 

1.  What  is  the  exciting  cause  of  the  attack  P 

2.  What  is  the  cause  of  the  pain  ? 

3.  What  is  the  actual  condition  we  are  called  upon  to 
treat  ? 

^.  What  part  of  the  animal  system  is  it  best  to  operate 
through — the  digestive  or  the  nervous  ?  Or  should  our  attack 
he  directed  mainly  upon  the  offending  substance  itself  ? 

1.  What  is  the  exciting  caiise  of  the  attack  ?  To  that 
question  I  answer.  Undoubtedly  in  the  great  majority 
of  cases  it  is  the  nature,  bulk,  or  mode  of  administration 
of  the  horse's  food.  Whether  of  an  indigestible  nature, 
given  in  too  large  a  quantity,  or  whether  given  in  such  a 
manner  and  at  such  a  time  as  not  to  admit  of  a  free 
action  upon  it  by  the  gastric  and  intestinal  fluids,  the 
result  remains  the  same — viz.,  impaction  of  a  certain 
portion,  or  portions,  of  the  alimentary  tract  with  a  mass 
of  improperly  digested  food. 

2.  What  is  the  cause  of  the  pain  ?  The  pain,  I  think 
we  may  safely  answer,  is  brought  about  by  active  peri- 
stalsis, followed  by  spasm  of  the  bowel,  either  on  both 
sides  of,  or  before,  or  behind  the  point  of  obstruction. 
This  pain,  of  the  severity  of  which  we  may  judge  by 
noting  the  animal's  symptoms  in  the  most  acute  case 
of  obstruction  we  have — viz.,  twist — we  may  designate 
as  cramp.  This  explanation  of  '  cramp,'  however,  does 
not  altogether  meet  the  case  when  we  are  talking  of 
obstructive  colic   in   its   subacute    form.     Here,  in    the 


Q4  THE  COMMON  COLICS  OF  THE  HORSE 

majority  of  cases,  we  have  a  state  of  impaction  from  end 
to  end  of  the  aHmentary  tube.  What,  then,  will  be  the 
cause  of  the  pain  now  ?  It  may  be,  and  is  partly,  due  to 
pressure  on,  and  consequent  irritation  of,  the  delicate 
nerve-endings  in  the  bowels  themselves.  When,  how- 
ever, we  consider  that  the  bowels,  already  crammed 
to  their  full  with  half-digested  matter,  are  sometimes 
further  distended  by  the  evolution  of  gases  from  the 
accumulated  faecal  masses,  we  may  confidently  assert 
that  we  have  another  and  totally  different  condition  of 
the  bowels  to  reckon  with.  I  am  alluding  to  'tonic 
spasm.'  When  a  muscle  or  its  motor  nerve  receives 
an  abnormal  number  of  vibrations  or  is  overstimulated, 
instead  of  contraction  being  followed  by  relaxation, 
permanent  contraction  or  tetanus  ensues.  The  bowels, 
distended  beyond  a  certain  point,  are  retained  in  a  state 
of  tonic  cramp  in  their  ineffectual  attempts  to  deal  with 
the  enormous  masses  they  contain.  That  this  is  so  is 
fully  proved  by  the  entire  cessation  of  peristalsis  in  many 
of  our  cases,  as  witnessed  by  auscultation.  Call  it  tonic 
spasm,  atony,  paralysis  of  the  bowel,  or  what  we  will,  it 
still  remains  that  we  have  a  torpid  and  stationary  condi- 
tion of  the  bowels  to  treat.  It  is  this  state  of  tonic 
spasm  of  the  whole  of  the  intestinal  tract  that  has, 
in  my  opinion,  been  so  generally  overlooked  in  the 
treatment  of  veterinary  obstructive  colic. 

3.  What  is  the  actual  condition  we  are  called  npon  to 
treat  ?  The  favourite,  but  evasive,  reply  of  the  practi- 
tioner of  veterinary  medicine  to  that  question  is, '  Remove 
the  cause,  and  the  effects  or  actual  condition  will  cease,' 
and,  accordingly,  in  every  case  he  gives  a  dose  of  physic. 
That  physic  is  invariably  aloes.  I  maintain,  however, 
that,  before  we  proceed  in  an  attempt  to  empty  the 
bowels  by  such  a  mechanical   method  as  the  adminis- 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON    95 

tration  of  aloes,  we  ouglit  rather  to  stay  and  ask  our- 
selves :  *  Can  we  by  any  other  means  put  the  tetanized 
wall  into  a  state  approaching  its  normal  condition,  and 
so  enable  it  itself  to  deal  with  the  offending  obstruction  ?' 
I  think  we  can,  and,  reserving  my  reasons  for  so  saying, 
will  conclude  my  remarks  on  this  question  by  stating 
that,  in  my  opinion,  it  is  the  tonic  spasmodic  seizure  of 
the  bowel  itself  which  is  the  actual  condition  we  are 
called  upon  to  treat  in  obstructive  colic. 

4.  What  part  of  the  animal  system  is  it  lest  to  operate 
through — the  digestive  or  the  nervotis  ?  Or  should  our 
attack  he  directed  mainly  against  the  offending  substance  itself? 
The  whole  crux  of  the  argument  concerning  the  treat- 
ment of  obstructive  colic  lies  in  the  answer  to  these 
questions.  For  my  own  part,  I  believe  that  the  treat- 
ment of  the  nervous  division  of  this  ailment  should 
receive  our  almost  undivided  attention ;  and  I  further 
believe  that  the  administration  only  of  drugs  that  act 
wholly  or  mainly  on  the  digestive  tube  itself,  and  not 
on  its  nervous  supply,  is  unproductive  of  good,  if  not 
altogether  harmful.  Remember,  we  cannot  depend  on 
the  physiological  action  of  the  drug  being  sure  to  ensue 
in  this  case.  We  are  putting  our  drug  into  contact  with 
a  diseased  organ,  and  must  not  expect  that  organ  to 
take  up,  assimilate,  and  respond  to  that  drug  as  the 
same  organ  would  do  in  health.  In  this  case  the  disease 
of  the  organ  is  its  atony,  spasm,  or  paralysis.  Relieve 
that,  and  the  bowels  will  relieve  their  impaction  them- 
selves. 

Intestinal  movements  are  dependent  on  the  ganglia  of 
Auerbach's  plexus,  situated  between  the  longitudinal 
and  inner  circular  layers  of  muscle.  Secretion  is  believed 
to  be  influenced  by  Meissner's  plexus,  lying  in  the  sub- 
mucous coat.     Both  of  these  ganglia,  however,  are  con.' 


96  THE  COMMON  COLICS  OF  THE  HORSE 

trolled  by  cerebro-spinal  centres  and  nerves,  notably  the 
vagi  and  the  splanchnics.  Here,  then,  is  pointed  out 
a  ready  and  open  road  to  a  correct  treatment,  and  one 
which  may  be  followed  without  the  aid  of  a  single  dose 
of  purgative  medicine.  Give  a  large  enough  dose  ol 
a  cerebro-spinal  stimulant,  and  theoretically  the  case 
should  at  once  begin  to  mend.  Practice  in  this  case, 
I  can  confidently  state  from  experience,  only  bears  the 
theory  out.  To  make  my  standpoint  clear,  I  must 
analyze  a  few  of  the  actions  of  the  more  important  drugs 
used  in  everyday  practice  in  the  treatment  of  this  dis- 
order. As  in  this  chapter  I  determine  to  direct  attention 
to  what  I  believe  to  be  the  dangerous  practice  of  giving 
aloes,  and  to  the  greater  success  following  a  nervous 
stimulant  treatment,  I  shall  confine  myself  to  a  few  drugs 
under  those  headings,  concluding  with  a  brief  paragraph 
on  the  use  of  anodynes  and  sedatives. 

(a)  Aloes. — Reasons  advanced  in  favour  of  its  adniimsf ra- 
tion :  It  causes  a  purge,  not  only  of  the  bowels,  but  also 
of  the  blood.  While  in  contact  with  the  intestine  it  pro- 
duces secretion  and  peristalsis.  It  also  increases  the 
flow  of  bile. 

Reasons  why  it  should  not  he  used  :  i.  The  length  of  time 
it  takes  to  act  (sixteen  to  twenty-four  hours)  is  much  too 
long  to  have  to  wait  in  the  horse  for  an  action  of  the 
bowels.  That  must  be  evident  to  everyone  in  view  of 
the  short  time  that  is  occupied  in  the  passage  of  the  food 
through  the  digestive  organs. 

2.  We  are  waiting  then  for  a  something  only  proble- 
matical ;  for  oftentimes  it  never  acts  at  all,  but  is  excreted 
wholly  by  the  kidneys,  causing  hyperasmia  of  those  organs 
and  diuresis. 

3.  The  drug  is  always  more  or  less  nauseating. 

4.  Its  effects  are  confined  mainly  to  the  large  intestine  ; 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON     g") 

consequently,  if  atony  of  the  small  intestine  exists,  it  may 
never  reach  the  position  in  which  its  action  will  be  the 
most  marked. 

5.  It  needs  to  be  saponified  and  emulsified  by  bile  before 
its  prompt  solution  can  be  counted  upon. 

These  last  two  reasons  may  be  considered  a  little  more 
in  detail.  It  is  they  that  have  already  made  me  refer  to 
the  action  of  aloes  as  '  mechanical.'  In  face  of  state- 
ments Nos.  4  and  5,  no  one  will  dispute  that  two  purely 
mechanical  processes  have  to  be  gone  through  before  we 
can  confidently  calculate  on  a  dose  of  aloes  creating  a 
purge.  It  has  to  pass  almost  passively  through  the  small 
intestines  before  it  can  reach  the  large,  and  it  requires 
also  to  be  mechanically  mixed  with  bile  before  its  solution 
can  be  expected.  Unfortunately,  in  subacute  obstructive 
colic  these  very  two  processes  that  are  necessary  for  the 
prompt  action  of  aloes  are  not  at  all  likely  to  come  about. 
Regarding  the  first,  I  have  already  pointed  out  that  there 
is  very  little  movement  of  the  bowels  in  this  form  of  colic  ; 
consequently,  the  drug  may  remain  almost  stationary  in 
the  stomach,  or  at  the  most  gain  the  first  few  feet  of  the 
small  intestines. 

With  regard  to  the  second  process  comment  is  well- 
nigh  useless.  In  subacute  obstructive  colic  there  very 
frequently  is  considerable  jaundice  and  torpidity  of  the 
liver,  in  which  case  the  aloes  cannot  act,  or,  to  say  the 
least,  its  action  is  most  certainly  delayed,  owing  to  the  fact 
that  the  bile  necessary  for  its  prompt  emulsification  and 
solution  is  deficient  or  altogether  wanting. 

6.  Finally,  in  the  horse  there  is  always  a  danger  of 
superpurgation,  followed  by  enteritis,  laminitis,  or  possibly 
death.     This  ought  never  to  be  overlooked. 

I  am  sure  that  every  practitioner  who  has  been  in  the 
habit   of  exhibiting    aloes   in    this    disorder    must   have 

7 


98  THE  COMMON  COLICS  OF  THE  HORSE 

sometimes  been  grievously  disappointed  and  mortified — 
disappointed  and  annoyed  to  see  his  case  recover  from 
the  disease  he  has  been  treating  it  for,  only  to  turn 
round  and  die  in  a  few  short  hours  as  a  result  of  the 
treatment  itself.  Truly,  that  treatment  was  worse  than 
the  disease.  I  say  here  that,  if  there  is  a  possibility  of 
that  occurring  in  only  i  per  cent,  of  our  cases,  then  aloes 
ought  never  to  be  used.  As  a  matter  of  fact,  when  aloes 
is  regularly  given,  it  happens  very  much  more  often  than 
that.i 

(b)  Ammonia. — Although  there  are  many  more  to 
choose  from,  the  drugs  I  have  used  as  stimulants,  and 
more  particularly  as  nervous  stimulants,  have  been 
ammonia  and  nux  vomica. 

For  ammonia,  and  especially  the  carbonate,  I  have  a 
particularly  strong  penchant.  That  I  am  not  the  only 
one  so  inclined,  I  Avill  show  by  a  few  remarks  extracted 
from  an  article  on  *  Ammonia  and  the  Stimulative  System 
of  Treatment  in  Disease.'  This  was  written  by  the  late 
Principal  Walley,  in  1879  ;  but,  I  may  add,  I  had  arrived 
at  almost  similar  conclusions  long  before  reading  his 
opinions.     He  says : 

'  Physiologically  ammonia  acts  as  a  powerful  stimu- 
lant, but  does  not,  like  alcohol,  increase  mental  activity, 
nor  does  it  to  the  same  extent  increase  the  force  of  the 
circulation.  Its  action  as  a  stimulant — owing  to  its 
being  quickly  excreted — is  as  fugitive  as  it  is  rapid,  but 
it  does  not  produce  much  secondary  depression.  .  .  . 
It  is,  too,  a  powerful  stimulant  to  all  the  glands  of  the 
body,  as  well  as  to  the  mucous  surfaces  generally,  acting 
upon  the  mucous  membrane  of  the  alimentary  tract, 
upon  the  kidneys,  the  skin,  and  the  liver.  Its  effects 
as  a  general  gland  stimulant  are  well  seen  in  those  cases 
where  the  pulse  is  firm,  the  skin  dry,  the  kidneys  in- 
^  See  Appendix  HI. 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON    99 

active,  the  mucous  membranes  icteric,  the  bowels  sluggish, 
and  the  faeces  coated  with  mucus,  with  a  hot,  dry,  and 
furred  condition  of  the  mouth.  A  few  doses  of  ammonia 
here  will,  by  stimulating  gland  function,  rapidly  alter  these 
conditions.  In  the  stomach  and  intestines  ammonia  acts 
as  an  antacid  and  antitympanitic.  It  is  useful  in  acute 
or  subacute  indigestion  in  horses  and  cattle  when  pur- 
gatives have  failed  to  act,  and  the  animal  shows  signs 
of  exhaustion,  alternated  with  strychnine  or  nux  vomica. 
In  the  early  stages  of  tympany,  the  liquor  or  the  car- 
bonate unites  with  the  liberated  carbonic  acid,  and  fixes 
it,  and  in  any  stage  is  beneficial  by  stimulating  the 
mucous  membrane  to  increased  activity,  by  rousing 
nervous  energy,  and  by  assisting  in  preventing  decom- 
position.' 

Like  Professor  Walley,  I  can  speak  from  experience 
as  to  the  beneficial  actions  of  this  drug  in  subacute 
indigestion,  and  I  prefer  the  carbonate  for  these  reasons : 
it  is  less  volatile  and  rather  more  permanent  in  its  actions 
than  the  hydrate ;  also  it  is  more  easy  of  administration, 
as  it  may  conveniently  be  given  in  the  form  of  a  bolus. 

{c)  Nux  Vomica. — I  consider  the  use  of  this  drug  to 
be  specially  indicated  in  the  treatment  of  subacute  obstruc- 
tion. It  is  a  gastric,  vascular,  and  nervous  tonic,  and 
antiparalysant ;  and  considering  that  I  have  already 
pointed  out  that  the  condition  we  are  to  treat  in  this 
disorder  is  mainly  one  of  nervous  atony  and  spasm  of  the 
bowel,  it  must  be  apparent  to  everyone  that  none  but  the 
most  favourable  results  will  follow  its  administration. 
I  must  not  finish  my  remarks  on  this  drug,  however, 
without  a  brief  reference  to  two  articles  in  the  Journal  of 
Comparative  Pathology  and  Therapeutics  (vol.  v.).  Two  cases 
are  reported  there  of  salivation  caused  by  the  administra- 
tion of  nux  vomica  in  3i.  and  Jii.  doses  respectively. 
The  dose  I  am  about  to  advocate  exceeds  this  by  6  or 

7—2 


ICX3  THE  COMMON  COLICS  OF  THE  HORSE 

7  drachms,  and  I  can  confidently  assert  that  in  no  single 
case  have  I  observed  anything  of  a  similar  nature. 

{d)  Turpentine. — It  will  be  seen,  on  referring  to  the 
section  on  Posology,  that  in  every  case  I  advocate  the  use 
of  turpentine  combined  with  linseed-oil.  I  have  chosen 
that  drug  on  account  of  its  antiseptic  and  stimulant 
actions.  I  have  given  it  mainly  to  satisfy  local  prejudice, 
which  thinks  that  no  medicine  can  be  a  medicine  unless 
in  the  form  of  a  drench,  and  have  selected  it  particularly 
as  conforming  closely  to  the  lines  on  which  my  treatment 
is  based — viz.,  stimulative. 

{e)  Eserine  or  Physostigmine.— Regarding  the  use 
of  this  preparation,  I  have  nothing  to  say  that  is  not  in 
its  favour.  I  regard  it  as  the  most  valuable  of  all  recent 
additions  to  veterinary  medicines.  Should  we  give  it  to 
pregnant  animals  ?  In  vol.  ii.  of  the  Veterinary  Record 
Horner  describes  two  cases  of  mares  in  advanced  preg- 
nancy receiving  one-tenth  of  a  gramme  of  eserine  and 
aborting  soon  afterwards.  That  should  be  sufficient  to 
point  out  that  its  use  must  be  tempered  with  caution. 
Only  after  all  other  means  have  failed,  and  it  becomes 
not  only  a  question  of  the  life  of  the  foal,  but  of  that  of 
the  mother,  should  it  be  given.  For  my  own  part,  I 
have  given  it  to  in-foal  mares  repeatedly,  and  have  not 
met  with  an  untoward  result  yet.  With  this  one  excep- 
tion, I  firmly  believe  that  it  may  be  administered 
advantageously  in  every  case  of  subacute  obstructive 
colic. 

To  those  who  complain  of  its  action  being  uncertain 
and  unreliable,  I  would  reply  in  the  words  of  one  of  our 
greatest  veterinary  writers :  '  Give  a  dose  sufficiently 
large,  and  you  will  not  be  disappointed.'  It  will,  when 
all  our  other  efforts  have  proved  futile,  restart  that 
peristalsis,  which  means  life  to  our  patient,  and  whose 
cessation  means  death.     I  do  not,  however,  believe  a  full 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON    loi 

dose  to   be  always    necessary,  and    have   seen  doses  of 

1  grain  do  all  that  the  most  fastidious  would  require. 
That  dose  is  sufficient  to  incite  the  bowels  to  action  in 
most  cases,  and  that  without  an  exhausting  and  painful 
evacuation  of  large  volumes  of  faeces.  If  it  fails,  it  may 
safely  be  repeated  later  in  an  increased  quantity — say, 

2  grains,  beyond  which  it  is  not  wise  to  push  its  ad- 
ministration. 

(/)  Pilocarpine. — In  this  drug  we  have  a  most  useful 
adjunct  to  eserine.  Possessing  as  it  does  the  property  of 
promptly  and  energetically  stimulating  glandular  secre- 
tions, including  the  salivary  and  intestinal,  it  at  once 
recommends  itself  for  use  in  the  disorder  we  are  con- 
sidering. While  in  eserine  we  have  an  agent  which  in 
large  measure  confines  itself  to  exciting  to  action  the 
muscular  coat  of  the  bowel,  we  possess  in  pilocarpine  a 
drug  whose  administration  will  cause  the  various  gastric 
and  intestinal  juices  to  be  secreted  in  large  quantities  and 
poured  into  the  bowel.  It  is  plain,  therefore,  from  a 
physiological  point  of  view,  that  the  exhibition  of  a  com- 
bination of  these  two  will  be  an  ideal  method  of  dealing 
with  obstruction  caused  by  accumulated  faecal  matter, 
and  accompanied  with  torpidity  of  the  bowel  wall. 

Practice  quite  bears  this  out.  It  is  true  that  it  is  only 
since  1904  that  I  have  been  in  the  habit  of  using  it.  I 
have  given  it  a  sufficiently  long  trial,  however,  to  prove 
its  usefulness.  This,  combined  with  eserine,  I  am  now 
convinced  is  far  preferable  to  the  exhibition  of  eserine 
alone.  As  to  the  dose,  I  have  found  that  i  grain  of 
eserine  in  conjunction  with  2  grains  of  the  pilocarpine  is 
satisfactory  and  efficient. 

{g)  Arecoline. — Of  late  years  the  use  of  arecoline 
hydrobromide  as  an  intestinal  stimulant  has  crept  to 
the  front.  Its  action  is  said  to  be  allied  to  that  of  pilo- 
carpine, but  of  somewhat  shorter  duration.     Although  I 


I02  THE  COMMON  COLICS  OF  THE  HORSE 

have  used  it  on  several  occasions,  I  have  not  been 
sufficiently  impressed  by  the  results  obtained  to  substitute 
it  for  the  combination  of  eserine  and  pilocarpine. 

(h)  Sedatives. — Our  choice  of  these  is  a  large  one, 
but  before  saying  more  I  would  ask :  '  Should  we  give 
sedatives  at  all  in  obstructive  colic  ?'  Personally,  I 
think  we  should  not.  I  know  that  in  saying  so  I  am 
opposed  to  a  large  number  of  practitioners,  but  still, 
after  the  experience  of  a  very  large  number  of  cases, 
such  is  my  conviction.  In  the  horse  I  am  convinced 
we  have  a  type  of  colic  to  deal  with  that  can  in  no 
way  whatever  be  compared  with  the  same  disorder  in 
the  human  subject ;  and  when  reading  the  report  of  a 
case,  nothing  gives  me  greater  annoyance  than  to  find 
the  veterinary  writer  trying,  in  conclusion,  to  bolster 
up  his  theories,  arguments,  and  treatment  with  extracts 
from  books  on  human  medicine.  As  a  profession,  we 
are  undoubtedly  largely  indebted  to  the  medical  for 
much  kind  help  afforded  us  in  the  first  tottering  steps  of 
our  babyhood.  Now,  however,  we  can  and  must  stand 
alone.  We  have  here  a  subject  that  fairly  allows  us  to 
do  so.  It  needs  a  distinct  and  totally  different  line  of 
thought  from  that  the  medical  profession  can  supply  us 
with  in  order  to  enable  us  to  properly  grapple  with  it. 
There  is  still  room  for  special  research  of  the  most  pains- 
taking order.  What  is  wanted  is  a  long  array  of  con- 
secutive cases,  with  notes  and  remarks  taken  on  the 
spot,  and  not  afterwards  altered  and  enlarged  in  order  to 
fit  in  with  some  preconceived  idea.  In  the  tabulation  of 
cases,  points  invariably  strike  one  that  would  otherwise 
be  missed — points  of  value  and  interest  that  only  a 
method  like  that  will  show  up. 

Think  for  a  moment.  Think  that  immediately  we 
give  a  sedative,  especially  if  that  sedative  be  opium, 
peristalsis  is   hindered,  if  not  stopped  altogether,  for  a 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON     103 

while.  Think,  again,  that  cessation  of  peristalsis,  if  only 
of  a  few  hours'  duration,  is  to  the  horse  a  very  grave  and 
serious  matter.  It  is  no  use  blinding  ourselves  with  the 
idea  that,  if  aloes  has  previously  been  given,  we  may 
safely  lull  the  pain  while  the  aloes  continues  to  act. 
Remember  that  '  lulling  the  pain  '  to  a  very  great  extent 
means  also  'lulling  the  physic,'  and  that  lulling  the 
bowels  in  the  horse  suffering  from  subacute  obstruction, 
with  bowels  already  stagnant,  means  lulling  him  to  death. 
Although  I  do  not  advise  it,  to  those  who  must  and  will 
use  a  sedative,  let  me  recommend  to  them  the  use  of 
chloral  hydrate  in  i -ounce  doses  in  preference  to  opium. 
It  is  antiseptic  in  its  action  ;  there  are  not  the  after  bad 
constipating  effects  of  opium,  there  is  not  that  mad 
delirium,  and  there  is  not  the  amount  of  dangerous 
tympany  that  opium  invariably  calls  up.  It  is  safe  to 
use,  its  action  is  soon  apparent — usually  well  within  ten 
minutes — and  if  its  effects  are  somewhat  transient,  why, 
then  the  same  dose  may  safely  be  repeated  after  a  short 
space  of  time.  It  is  not  followed  by  nausea,  and,  com- 
pared with  opium,  it  does  not  seriously  interfere  with  the 
peristaltic  movements,  and  does  not  hinder  intestinal 
secretions.  Here,  again,  I  have  notes  of  a  case  in  front 
of  me  where  the  veterinary  writer  states  that  medical 
men  pooh-pooh  the  idea  of  chloral  being  of  any  use  in 
these  cases.  Well,  let  them  do  so.  They  are  not  in  the 
habit  of  prescribing  for  the  horse,  they  are  not  acquainted 
with  his  internal  anatomy,  and  they  certainly  are  not 
largely  experienced  in  the  action  of  drugs  upon  him. 
That  chloral  is  not  an  anodyne  in  the  strict  sense  of  the 
word,  I  know.  I  know  that  it  does  not  act  as  a  sedative 
to  the  periphery  of  sensory  nerves.  It  acts,  however,  in 
an  indirect  manner  through  the  nerve-centres,  and  almost 
invariably  induces  sleep.  Compare  the  stretched-out, 
comfortable   sleep  of  the  griped  animal   under   the  in- 


104  'THE  COMMON  COLICS  OF  THE  HORSE 

fluence  of  chloral  with  the  mad  delirium  so  often  seen 
with  opium,  and  one  can  no  longer  remain  in  doubt  as  to 
the  superiority  of  the  former  in  treating  equine  colic. 

Here  are  a  few  of  Mr.  Hunting's  remarks  on  the  use 
of  sedatives  in  colic,  and  with  them  I  must  close.  He 
says  :  *  It  was  argued  that  in  the  human  subject  they 
administered  sedatives  with  the  intention  of  alleviating 
the  pain,  and  when  they  had  once  stopped  the  spasm 
there  w^as  no  fear  of  impaction.  After  the  spasm  w^as 
got  rid  of,  that  the  normal  condition  of  the  bowels 
would  be  resumed,  and  the  indigestion  pass  away. 
Personally,  he  (Mr.  Hunting)  believed  that,  so  far  as  the 
horse  was  concerned,  that  was  arguing  upside  down. 
He  held  that  the  impacted  food  was  the  cause  of  the 
spasm  or  pain,  and  that  the  proper  thing  to  do  was  to 
remove  the  cause,  even  if  they  inflicted  a  Httle  more  pain. 
He  could  say  honestly  and  fairly  that  he  had  had  a 
greater  number  of  recoveries  under  the  aperient  and 
stimulant  treatment  than  under  the  sedative  treatment 
alone.' 

I  can  emphatically  endorse  all  that  Mr.  Hunting  says 
there.  The  same  good  results  immediately  followed 
when  I  refrained  from  giving  sedatives.  I  am  able, 
moreover,  to  assure  the  practitioner  that  the  number  of 
his  successful  cases  would  further  increase  if  he  also 
discontinued  the  use  of  aloes,  and  substituted  linseed- 
oil. 

Posology. — Provided  the  animal  is  suffering  from  a 
bad  attack  of  the  disorder,  with  all  the  symptoms  well 
marked,  and  the  least  possible  chance  of  error  in  diagnosis, 
I  exhibit  the  following  : 

R.  Ammon.  carb.  pulv.    -        -    §ii. 
Nucis  vom.  pulv.  -         -     ^[. 

Sapo  mollis  -         -         -     q.s.  ut  fiat  bol. 

Misce  ;  fiat  bol.  iv. 
Sig.  :  The  four  balls  to  be  given  at  once. 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON    105 

R.  Ol.  tereb.  ^ 

Spt.  ammon.  ar.  J  ^ 

01.  lini   ---..-     ad  O.i- 
Misce  ;  fiat  haust. 
Sig.  :  The  drench  to  be  given  at  once. 

This  treatment,  with  the  exception  of  the  nux  vomica, 
I  repeat  again  at  the  expiration  of  three  to  four,  five,  or 
six  hours  if  the  animal  is  still  in  pain.  In  the  meantime 
I  throw  up  frequent  enemata  of  hot  water,  with  some- 
times the  addition  of  4  to  6  ounces  of  ordinary  soap 
liniment.  Should  the  case  tend  in  any  way  to  become 
protracted,  and  if  the  pulse  is  strong  and  not  too  frequent, 
I  inject  hypodermically  eserine  sulphate,  i  grain.  If  on 
the  next  occasion  of  my  seeing  the  case  there  has  been 
no  action  of  the  bowels,  and  peristalsis  is  still  in  abeyance, 
I  repeat  the  eserine  in  larger  quantities — viz.,  2  grains. 

The  preparation  of  eserine  that  I  have  found  to  be  the 
most  reliable  is  the  following  : 

^.  Eserine  sulph.     -         .         -     grs.  viii. 

Aq.  chloroformi  -        -     ad  gi. 

Dose,  I  to  2  drachms. 

I  would  recommend  every  practitioner  to  prepare  this 
himself.  He  will  have  the  satisfaction  of  knowing 
exactly  the  strength  of  his  injection,  and  he  may  rely  on 
that  preparation  keeping  practically  for  any  length  of 
time.  It  should  be  made  in  fairly  large  quantities 
(say  12  ounces),  and,  during  the  handling  of  the  raw 
drug,  it  should  be  remembered  that  it  is  highly  hygro- 
scopic.-^ 

So  long  as  the  animal  remains  ill,  I  continue  the 
administration  of  ammonium  carbonate,  this  time  com- 
bined with  zingib.  rad.  pulv.  in  place  of  nux  vomica.  In 
fact,  it  may  be  taken  as  a  general  rule  that  from  the  com- 

^  This,  too,  may  be  obtained  in  tablet  form,  in  varying  combina- 
tions with  pilocarpine,  and  quite  reliably  dispensed,  from  any  firm 
of  druggists  of  repute. 


io6  THE  COMMON  COLICS  OF  THE  HORSE 

mencement  of  the  pains  until  relief  is  obtained  ammonium 
carbonate  may  be  given  at  intervals  of  three  hours  in 
I  to  2  ounce  doses. 

The  only  modification  to  be  made  is  when  treating  a 
very  young  cart  animal  or  a  nag.  In  this  case  the  dose 
of  nux  vomica  should  be  reduced  to  half  an  ounce. 

Should  the  reader  think  these  doses  too  large,  I  would 
ask  him  to  remember  that  the  results  embodied  in  the 
writing  of  this  chapter  are  the  outcome  of  several  years' 
sole  practice  of  the  treatment  here  laid  down,  and  that 
nothing  but  the  marvellous  and  striking  statistics 
following  its  adoption  have  led  me  to  give  to  it  the 
prominejice  I  have  done  in  the  past  few  pages. 

To  anyone  who  might  feel  disposed  to  adopt  it  I 
would  offer  a  few  words  of  caution.  If  carried  out  in  a 
half-hearted  manner — the  doses  reduced  by  one-half  to 
guard  against  accident,  or  the  administration  of  eserine 
deferred  until  the  patient  is  in  a  state  of  collapse — then 
he  may  look  for  nothing  but  failure.  Having  diagnosed 
his  case,  the  veterinarian  must  be  possessed  of  the 
courage  of  his  convictions,  and  be  prepared  to  push  them 
to  their  ultimate  and  right  conclusion. 

Should  he  doubt,  should  he  waver,  I  am  able  to 
honestly  assure  him  that  I  have  seen  no  case  in  which 
the  apparently  excessive  doses  have  proved  in  any  way 
harmful.  On  the  contrary,  after  the  experience  of  a  long 
array  of  cases,  I  am  able  to  declare  the  exact  opposite  to 
be  the  fact,  and  am  thereby  led  to  insist  so  strongly  on 
the  correctness  of  the  treatment.  In  the  whole  of  my 
practice  for  certainly  the  last  five  or  six  years  I  have 
had  no  occasion  save  one  to  give  aloes.  That  occasion 
is  included  in  the  fist  of  cases  at  the  end  of  this  chapter, 
and  I  may  say  that,  even  then,  I  had  serious  cause  to 
regret  its  administration.  This  section  on  posology  is 
the  one  I  would  ask  the  reader  to  ponder  over  most.     If 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON    107 

my  description  of  the  disorder  is  correct,  there  can  be  no 
doubt  that  the  treatment  is  right  in  every  detail. 

To  further  set  at  rest  the  mind  of  those  who  think  the 
doses  of  ammonium  carbonate  beyond  all  reasonable 
limit,  I  may  state  here  that  one  animal,  in  addition  to 
the  usual  doses  of  nux  vomica  and  ol.  tereb.,  received 
considerably  over  i  pound  of  that  drug — i  pound  in 
2-ounce  doses  spread  over  a  period  of  thirty  hourso  I 
need  hardly  say  it  was  an  extreme  case.  It  is  the 
occurrence  of  cases  like  that  which  has  proved  to  me  the 
value  of  the  treatment— cases  that,  under  the  old  treat- 
ment of  aloes  and  sedatives,  invariably  used  to  die. 
Only  a  few  trials  will  convince  any  unbiassed  mind  of 
the  splendidly  beneficial  action  of  a  solely  stimulative 
treatment.^ 

Although  very  much  more  might  be  written  on  this 
subject,  I  feel  that  already  this  chapter  is  lengthy  enough. 
My  main  object  has  been  to  point  out  what  I  believe  to 
be  the  dangerous  though  common  practice  of  administer- 
ing aloes  or  sedatives  to  the  horse  suffering  from 
intestinal  obstruction  in  its  subacute  form.  One  can 
always  see  more,  feel  more,  and  know  more  than  one  can 
write.  It  is  not  easy  to  gather  up,  classify,  and  tabulate 
all  the  facts,  theories,  and  circumstances  that  lead  one  to 
a  certain  conclusion.  It  is  still  less  easy  to  so  arrange 
those  facts  as  to  carry  conviction  to  the  minds  of  others. 
If  I  have  failed  in  that,  I  have  failed  in  a  good  cause. 
If  I  have  been  successful,  I  am  conscious  of  having  per- 
formed a  good  work  for  my  brother  veterinarian,  for  the 
stock-owner,  and  for  our  equine  patients. 
1  See  also  Part  II.  of  Appendix. 


108  THE  COMMON  COLICS  OF  THE  HORSE 

REPORT  ON  EIGHTEEN  CONSECUTIVE  CASES  OF 


No. 

0/ 

Case. 

Date. 

ritve. 

Subject 
and  Age. 

1 

t 

^ 

Resp. 

Conjunc- 
tiva. 

Since  hoiv 
long  III. 

Diet. 

I 

Oct.  lo, 

1898. 

7- 30 
p.m 

5-years- 
old  cart 
gelding. 

70 

ioi*6 

14 

Injected. 

7  a.m. 
same  day. 

No  green  meat. 
A  mixture  of 
maize,  boiled 
potatoes,  and 
barley  -  meal ; 
soaked  linseed 
cake. 

2 

Oct.  II. 
Oct.  12. 

8.45 
p.m 

10 
a.m. 

13-years- 

old  brown 

cart 

gelding. 

88 

103-4 

36 

Highly 
injected. 

II  a.m. 
same  day. 

Ground  maize, 
new  oa's,  and 
cut  new  oat 
straw ;  soaked 
linseed  cake. 

3 

Oct.  12. 

Oct.  13. 
Oct.  14. 

2.30 
p.m. 

10.30 
a.m. 

10.30 
a.m. 

22-years- 
old  black 
cart  mare ; 
had  been 

used 

largely  fi.r 

breeding  ; 

barren. 

48 

43 

88 

99 '6 

99-6 
101 

13 

13 
13 

Highly 
injected. 

and 
yellow. 

Do. 

Do. 

6  p.m. 
of iilh. 

New    oals,   cut 
oat  straw,  old 
hay,     kohl 
rabi ;     soaked 
linseed  cake. 

SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON        109 
SUBACUTE  OBSTRUCTIVE   INTESTINAL  COLIC. 


Water- 
supply. 

Previous 
Medicine. 

Medicine  given. 

Sympto7iis,  Remarks,  etc. 

Rain. 

Nil. 

At  7.30  p.m. 
Ammon.  carb.,  2^  oz. 
Nucis  vom.  p.,  i  oz. 
Sapo  mollis,  q.s. 

M.  ;  ft.  bol.  iv. 

At  9.30  p.m. 
01.  tereb.,  2  oz. 
Spt.  ammon.  ar.,  i  oz. 
01.  lini,  I  pint. 

M.  ;  ft.  haust. 

Dull  pains  at  intervals.    Lying  quiet.    Stand- 
ing quiet.     Eating  occasionally.     Rectum 
empty  and  ballooned.    I  watched  this  rnsp 
three-quarters  of  an  hour  before  pain  was 
evinced  at   all,  and   nearly   left   the  farm 
declaring  to  the   owner  that   I   had  been 
called  out  for  nothing.     I  did  not  see  the 
case  again,  and  it  afterwards  did  well. 

Drain 
(dyke). 

01.  iini, 
I  pint. 

Ammon.  carb.  p.,  2  oz. 
Nucis  vom.  p.,  i  oz. 
Sapo  mollis,  q.s. 

M.  ;  ft.  bol.  iv. 

General   dull  pains,    with   excessive  strain- 
ing attempts  at  defaecation  at   intervals. 
Symptonis   somewhat   masked,    owing  to 
pneumonia  (congestive   stage)  set  up  by 
the  inspired  linseed-oil  given  by  the  owner. 
Impossible,  or   rather   unwise,  to  drench. 
The  rectum  contained  a  few  hard  lumps 
covered  with  mucus,  and  the  bowel  was 
ballooned. 

Animal  quite  well  in  all  respects. 

Drain 

(dyke). 

Nil. 

Ammon.  carb.  p.,  2  oz. 
Nucis  vom.  p.,  i  oz. 
Sapo  mollis,  q.s. 

M.  ;  ft.  bol.  iv. 

Injected  hypodermically  : 

Eserine  sulph.,  2  grs. 

Treated    exactly    as     on 
previous  day,  with  ex- 
ception of  eserine.  Ene- 
mata  given. 

Treated  as  on  12th,  with 
the  addition  of  a  hypo- 
dermic dose  of  eserine, 
■^h  grs. 

Dull  heavy  pains  the  whole   time.     Never 
violent.     Impossible   to   drench  owing  to 
awkwardness.      Rectum  empty  and   bal- 
looned.    Other  bowels,  as  far  as  could  be 
felt,  impacted.     No  peristalsis  on  auscul- 
tation. 

Mare  much  weaker,  and  evidently,  owing 
to  old  age,   unable   to   stand  against  the 
attack.    Rectum  still  empty  and  ballooned. 
No  faeces  had  yet  been  passed. 

Still  no  fibces  had  been  passed,  and  still  no 
evidence  pf  peristalsis  could  be  gained  by 
auscultation.     The  temperature,  however, 
was  decidedly  improved  ;  and  the  pulse, 
having   gained    in    strength    and   become 
more  full  to  the  touch,  indicated  that  the 
mare  would  still   stand  active  treatment. 
Accordingly,  I  repeated  the  previous  treat- 
ment, and  also  ventured  on  another  and 
larger  dose  of  eserine  sulphate,  with  the 
happiest  results.      The   bowels  answered 
to  the  stimulus,  and  the  case  afterwards 
did  well. 

no 


THE  COMMON  COLICS  OF  THE  HORSE 


REPORT  ON  EIGHTEEN  CONSECUTIVE  CASES  OF 


No. 
Case. 

Date. 

"-  /r-ij; 

s 

^ 

Resp. 

Conjunc- 
tiva. 

Since  how 
long  III. 

Diet. 

4 

Oct.  14. 

10.15 

p.m. 

6-years- 
3ld  in-foal 

chestnut 
:art  mare. 

68 

101-4 

13 

Injected. 

3.30  p.m. 
same  day. 

Soaked     split 
maize  and  new 
oats.withbran, 
cut  oat  straw, 
old    hay,    ai.d 
linseed  cake. 

5 

Oct.  15. 
Oct.  16. 

10.45 
p.m. 

8  a  m. 

7-years- 
old  cart 
gelding. 

48 

iot'4 

A  con- 
tinual 
sob  of 
32  per 
minute. 

Injected 

and 
yellow. 

7  p.m. 
same  day. 

Green     clover, 
bran,     wheat, 
sharps,     and 
cut    hay    and 
straw. 

6 

Oct.  17. 

10.45 
a.m. 

14-years- 
old  nag 
gelding, 
property 
of  a 
miller. 

52 

lOI 

13 

Injected 

and 
yellow. 

7  p.m. 
of  i6th. 

Wheat      chaff, 
maize,      and 
bran. 

7 

Oct.  27. 
Oct.  28. 

6.30 
p.m. 

7-30 
a.m. 

24-years- 

old  brown 

cart 

gelding. 

108 
50 

100 

IOO'2 

12 
12 

Injected 

and 
yellow. 

Injected. 

3.30  p.m. 
same  day. 

Maize,   cut  oat 
straw,    wheat 
chaff,    soaked 
linseed  cake. 

8 

Nov.  17. 
Nov.  18. 

7-30 
p.m. 

10 
p.m. 

old  roan 

nag 
stallion. 

70 
62 

lOI 
lOI 

13 
13 

Injected 

and 
yellow. 

6  a.m. 
same  day. 

Out  at  pasture, 
but    receiving 
twice    daily 
two    feeds    of 
maize,      oats, 
and     wheat 
chaff. 

SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON         m 
SUBACUTE  OBSTRUCTIVE  INTESTINAL  COLIC— c:o;!//;n^m\ 


Water- 
supply. 

P)-cvious 
Medicine. 

Medicine  given. 

Symptoms,  Remarks,  etc. 

Dirty 

drain. 

01.     lini, 
I  pint. 

Ammon.  carb.  p. ,  2  oz. 
Nucis  vom.  p  ,  i  oz. 
Sapo  mollis,  q.s. 

M. ;  ft.  bol.  iv. 

Usual  dull  pains.  Animal  subject  to  these 
attacks,  and  with  difficulty  rallied  from  one 
in  August,  1896,  when  I  treated  her  with 
aloes  and  anodynes.  I  did  not  see  the  case 
again,  but  the  owner  afterwards  informed 
me  that  the  mare  did  well. 

Drain 
(dyke). 

01.  lini. 
01.   tereb. 

small 
quantity. 

Amnion,  carb.,  2  oz. 
Nucis  vom.  p.,  i  oz. 
Sapo  mollis,  q.s. 

M.;  ft.  bol.  iv. 

01.  lini,  10  oz. 

M.  ;  ft.  haust. 
Hypodermically  :  Eserine 
sulph.,  2  grs. 

Pams  violent.  Animal  almost  ungovernable. 
Ears  and  extremities  cold.  Cold  sweat 
bedewing  underneath  surface  of  abdomen, 
and  between  the  forearms  and  thighs. 
Expression  anxious.  Rectum  empty, 
ballooned,  and  dry.  Bladder  empty.  I 
watched  the  case  for  an  hour,  during  which 
there  was  not  one  moment  of  ease.  I  left 
her  in  pain. 

Mare  quite  well.  I  learned  from  the  owner 
that  the  animal  gained  ease  at  3  a.m.,  and 
first  passed  at  7  a.m.  a  large  mass  of  yellow 
mucus  weighing  3  pounds,  together  with  a 
few  hard  knots  of  faeces,  which  were  saved 
for  my  inspection. 

Soak  or 
surface- 
well. 

01.     lini, 
I  pint. 

Ammon.  carb.,  2J  oz. 
Nucis  vom.  p.,  i|  oz. 
Sapo  mollis,  q.s. 

M. ;  ft.  bol.  iv. 
01.  tereb.              1  __ 
Spt.  ammon.ar./^^3oz. 

01.  lini,  12  oz. 

M. ;  ft.  haust. 

Usual  dull  heavy  pains.  Rectum  contained 
a  few  hard  mucus-covered  lumps,  and  was 
ballooned.  Other  intestines  (colon)  could 
be  felt  impacted.  Bladder  empty.  Did 
not  see  the  case  again.     Did  well. 

Soak  or 
surface- 
well. 

Nil. 

As  Case  4. 
Did  not  treat. 

Had  been  in  violent  pain,  but  on  my  arrival 
was  standing  perfectly  quiet.  The  counte- 
nance, however,  looked  anxious,  and  I 
was,  to  say  the  least  of  it,  alarmed  at  the 
state  of  his  pulse. 

All  symptoms  of  pain  absent. 

Drain 
(dyke). 

01.     lini, 
I  pint. 

Ammon.  carb.  p.,  2  oz. 

Nucis  vom.  p.,  i  oz. 

."^apo  mollis,  q.s. 

M. ;  ft.  bol.  iv. 

01.  tereb.             )  .. 

Spt.  ammon.  ar.  1^*2  0^- 

01.  lini,  12  oz. 

M.  ;  ft.  haust. 

Repeated  the  same  treat- 
ment, with  the  addition 
of  eserine  sulphate,  2  grs. 

Usual  dull  pains.  No  evidence  of  peristal- 
sis on  auscultation.  There  had  been  no 
evacuation  of  faeces  all  day,  but  the  rectum 
was  full  of  a  semi-fluid  dark-green  mass. 
This  I  removed,  and  gave  enemata. 

Rectum  again  full,  but  there  had  been  no 
voluntary  evacuation  of  its  contents.  The 
case  subsequently  did  well,  and  there  was 
no  purging. 

THE  COMMON  COLICS  OF  THE  HORSE 
REPORT  ON  EIGHTEEN  CONSECUTIVE  CASES  OF 


No. 

of      Date. 
Case. 

"-  f:J-'Z. 

1 

Risp. 

Conjunc- 
tiva. 

Since  ho~a 
long  111. 

Diet. 

9 

Nov.  23. 

10.30 

a.m. 

Aged  (15?) 

in- foal 
cart  mare. 

57 

IOI-4 

12 

Injected. 

Found  ill 
at  5  a.m. 
same  day. 

Cut   oat  straw, 
wheat      chaff, 
maize. 

Nov.  23. 
Nov.  23. 

12.50 
p.m. 
7  p.m. 

- 

.. 

102 

12 

- 

- 

- 

loi 

Nov.  30. 

7 
p.m. 

5 -years- 
old  chest- 
nut cart 
gelding. 

62 

101 

17 

Normal. 

6  a.m. 
same  day. 

Bran,     maize, 
linseed,     cut 
oat  straw,  and 
wheat  chaff. 

Nov.  30 

10 
p.m. 

- 

- 

- 

- 

- 

- 

Dec.  I. 

7  a.m.          — 

— 

— 

- 

- 

- 

II 

Dec.  5. 

9.20 
p.m. 

5-years- 
old  nag 
mare; 
barren. 

65 

lOI 

^5 

Injected. 

12  noon 
same  day. 

Maize,     bran, 
ground  wheat, 
cut  oat  straw. 

Dec.  6. 

12 

noon. 

- 

- 

- 

- 

- 

- 

- 

Dec.  7. 

12 
noon. 

12 

Dec.  22. 

11.30 
p.m. 

2-years- 
old  cart 
gelding. 

44  to 

cord- 
ing to 
pain. 

104-4 

28, 
sobbing 

Injected. 

3  p.m. 
same  day. 

Cut  oat  sheaves, 
bran,     maize, 
mangels. 

On  the  night  of  November  30  I  had  also  two  other  cases  of  a  similar  nature. 

Circumstances  did  not  permit 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON        113 
SUBACUTE  OBSTRUCTIVE   INTESTINAL  COLIC -^c07!//;iued. 


IVafer- 
supply. 

Previous 
Medicine. 

Medicine  given. 

Sy>tiptoms,  Remarks,  etc. 

Dyke. 

Nil. 

Ammon.  carb.,  i\  oz. 
Nucis  vom.  p.,  6  drs. 
Sapo  mollis,  q.s. 

M.  ;  ft.  bol.  iv. 
Drench  as  for  No.  8. 

Injected  hypodermically  : 
Eserine  sulphate,  2  grs. 

Periods  of  dull  pain.  Violent  at  intervals. 
Slight  tympany.  Rectum  empty  and 
ballooned. 

No  change  whatever. 

Mare  quite  easy.  One  hour  after  the  injec- 
tion of  the  eserine  and  during  the  day 
there  had  been  several  evacuations  of  faeces 
of  a  normal  consistence,  accompanied  by 
the  discharge  of  much  flatus. 

Dyke. 

Nil. 

Same  as  No.  8,_vvith  addi- 
tion  of   eserine   sulph., 
2  grs. 

Dull  pains.  Rectum  ballooned  and  contain- 
ing a  few  hard  mucus -covered  lumps. 
Colon  impacted.  No  signs  of  peristalsis 
on  auscultation.  Tympany  very  marked. 
This  I  tried  to  relieve  with  the  trocar,  but, 
failing  twice,  desisted  at  owner's  urgent 
request. 

The  eserine  had  greatly  increased  peristalsis, 
but  as  yet  there  had  been  no  passage  of 
faeces. 

Horse  quite  easy.  Slightly  purging.  Case 
did  well. 

Surface - 
well. 

Nil. 

Ammon.  carb.,  2  oz. 
Nucis  vom.,  i  oz. 
Sapo  mollis,  q.s. 

M.  ;  ft.  bol.  iv. 
Spt.^ammon.ar.J^^^,. 

01.  lini,  10  oz. 

M.  ;  ft.  haust. 

I  was  in  this  case  tempted 
by  the  owner  to  give  a 
dose  of  aloes,  7  drs. 

Sharp  pain  at  intervals.  For  the  most  part 
remaining  dull.  Eating  at  intervals.  No 
tympany.  Rectum  full  of  a  semi-fluid, 
half -digested  material,  resembling  more, 
both  in  smell  and  appearance,  the  contents 
of  a  stomach. 

The  mare  continued  dull  all  day.  Purged 
towards  evening.  This  purging  I  could 
not  attribute  to  the  aloes,  as  it  was  too 
soon  after  its  administration. 

Mare  still  continued  dull  and  listless,  but 
picking  a  little.  Dung  of  a  normal  con- 
sistence. She  then  purged  again  towards 
evening  (this  time,  I  think,  from  the  aloes), 
and  caused  nie  no  little  anxiety  for  some 
few  days,  fearing  superpurgation  as  a  con- 
sequence of  the  already  irritated  bowels. 

Dyke. 

Nil. 

As  Case  11,  but  no  aloes. 
One  hour  later,  eserine 
sulph.,  2  grs. 

Pains  violent  and  almost  incessant.  Per- 
spiration in  patches,  but  animal  warm. 
An.\'ious,  distressed  look.  Mouth  dry, 
clammy,  and  hot.  The  horse  got  relief  at 
3.30  a.m.  on  23rd. 

These  were  treated  on  identical  lines  with  the  foregoing,  and  did  well, 
of  my  reporting  them  in  full. 


ll\ 


THE  COMMON  COLICS  OF  THE  HORSE 


REPORT  ON  EIGHTEEN  CONSECUTIVE  CASES  OF 


JVo. 
Case. 

Date. 

Time. 

Subject 
and  Age. 

V 

-^ 

^ 

1 

Resp. 

Conjunc- 
tiva. 

Since  hovj 
long  III. 

Diet. 

13 

Jan.   27, 

1899. 

3  pm- 

22-years- 

old  brown 

cart 

gelding. 

54 

98-4 

hurried, 

short, 

and 

gasping. 

Injected. 

12  noon 
same  day. 

16  pounds  of 
material  per 
diem,  consist- 
ing of  maize, 
(3  parts), 
wheat  (1 
part),  oat 
straw  and 
wheat  chaff. 

M 

Feb.  7. 
Feb.  7. 

5  p.m. 

10.30 
p.m. 

13-years- 

old   in-foal 

half-strain 

mare. 

52 
48 

99-2 
100 

20 
13 

Injected 

and 
yellow. 

12  noon 
same  day. 

I  stone  or  more 
per  diem  of 
miize,  bran, 
and  wheat 
sharps,  with 
cut  oat  straw. 
One  third  of 
the  mixture 
was  wheat. 

J5 

Feb.  8. 

8  p.m. 

4-years- 
old  cart 
gelding. 

40 

TOO 

16 

Normal. 

6  p.m. 
same  day. 

1  -stone  of 
mi.vture  of 
maize,  oats, 
and  ground 
wheat.  Oat 
straw,  hay 
chaff,  and 
carrots. 

16 

Feb.  13. 

7  p.m. 

4 -years- 
old   brown 
cart 
gelding. 

50 

101-4 

20 

Normal. 

3.^0  p.m. 
same  day. 

I  stone  or  more 
per  diem  of 
oats,  with  oat 
straw  and  cut 
hay. 

SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON         115 
SUBACUTE  OBSTRUCTIVE  INTESTINAL  COLIC— ^^;///V;?/^^?'. 


IVa/er- 
siipply. 

Previous 
Medicine. 

Medici7ie  given. 

Symptoms,  Remarks,  etc 

Dyke. 

01.  lini, 
I  pint. 

As  Case  ii.     No  eserine. 

In  this  case  the  bowels  had 
been  greatly  emptied  by 
repeated  evacuations  of 
small  quantities  of  faeces 
before  my  arrival. 

Started  work  at  7  a.m.  Continued  well  until 
12.30.  Received  the  mid-day  meal,  im- 
mediately after  which  she  was  ill.  Bathed 
in  perspiration.  Pains  violent  and  inces- 
sant. No  tympany  of  bowels.  Rectum 
and  colon,  as  far  as  could  be  felt,  empty. 
Rectum  flaccid.  Continually  looking  round 
at  stomach  (not  flank).  Medicine  return- 
ing through  nose.  Regurgitations  in 
oesophagus.  Pulse  gradually  got  higher 
in  number  and  weaker  in  tone,  and  one 
hour  after  my  first  arrival  I  diagnosed 
tympany  of  stomach,  with  possible  rupture 
and  death.  Death  occurred  at  i  a.m.  of 
28th,  and  I  much  regret  that  circumstances 
did  not  allow  of  a  post-mortem  being  made. 
There  was  no  rupture  of  stomach.  This 
case  shows  that  too  great  a  reliance  must 
not  be  placed  on  the  indications  of  pulse, 
temperature,  and  respiration  in  the  first 
stages  of  colic. 

Surface - 
well. 

Nil. 

As  Case  ii,  but  no  aloes. 
At  6  p.m.  injected  eserine 
sulph.,  I  gr. 

Pains  dull  when  animal  was  down.  Violent 
when  up.  With  difficulty  could  keep  mare 
on  her  legs.  Much  groaning  and  painful 
attempts  at  defalcation.  Rectum  empty 
and  ballooned,  but  mare  had  passed  a  few 
hard  lumps  of  mucus-covered  dung  during 
the  day.  Slight  tympany,  but  no  sign  of 
peristalsis  on  auscultation.  Animal  was  at 
work  from  7  to  11  a.m. 

Mare  quite  easy.  Drank  water  greedily. 
Picking  her  bedding.  Food  withheld  until 
morning.  Had  passed  immense  quantities 
of  flatus  and  one  large  heap  of  faeces. 

Surface- 
well. 

Nil. 

Amrnon.  carb.,  2  oz. 
Nucis  vom.,  i  oz. 
Sapo  mollis,  q.s. 

M.  ;  ft.  bol.  iv. 
Spt.  ammon,  ar.  1  :t-:  ^  ^^ 
01.  tereb.              [-'^'^oz. 
01.  lini,  10  oz. 

M.  ;  ft.  haust. 

Animal  had  been  at  work  in  the  morning. 
Dull  pains.  Rectum  ballooned  and  con- 
taining three  or  four  fairly  soft  dung-balls. 
Other  bowels  could  be  felt  impacted. 
Bladder  empty.     Case  did  well. 

Rain 
col- 
lected 
in  vat 
and 
soak- 
well. 

Gin, 

ginger, 

opium,  and 

linseed-oil. 

As  Case  15. 

Dull  pains.  Groaning  when  lying.  No 
peristalsis  on  auscultation.  No  tympany. 
Rectum  full ;  flaccid  when  emptied.  Case 
did  well. 

8—2 


iiG  THE  COMMON  COLICS  OF  THE  HORSE 

REPORT  ON  EIGHTEEN  CONSECUTIVE  CASES  OF 


Date. 

Time. 

Suhject 
and  Age. 

1 

Resjy. 

Conjunc- 
tiva. 

Since  htiv 
long  111. 

Diet. 

17 

Mar.  26. 

Mar.  26. 
Mar.  27. 

Mar.  27. 

3- 30 
p.m. 

9- 30 
p.m. 

10.30 
a.m. 

5- 30 
p.m. 

S-years- 
old  brown 

cart 
gelding. 

72 
50 
65 

46 

101 '2 

lOI 

IOl'2 

lOI 

13 
13 
13 

13 

Injected. 
Normal. 

Normal. 

10.30  a.H). 
same  day. 

Tains 

again 

com- 
menced 
at  5.30 

a.m. 

Maize,  cut  oat 
straw,  man- 
gels, and  lin- 
seed cake. 

18 

.April  I. 

April  I. 

April  I. 
April  I. 

10.30 
p.m. 

"•45 
p.m. 

8  a.m. 

12.45 
a.m. 

lo-years- 
old  cart 
mare  ; 
barren. 

72, 
inter- 
mit- 
tent. 

63 

103 
IOl'2 

17. 
sobbing. 

15 

Normal. 
Normal. 

3p.m 
same  day. 



Wheat  chaff, 
cut  oat  straw, 
oats,  linseed 
cake,  man- 
gels. 

Subacute  obstruction  of  the  double  colon     117 

SUBACUTE  OBSTRUCTIVE  INTESTINAL  COLIC— conf/;mt^d. 


IVater- 


Drain. 


Drain. 


Prcv  ous 
Medicine. 


Nil. 


Nil. 


Medicine  given. 


As  Case  15, 
and  eserine  sulph.,  2  grs. 


Enemata  and  repeated 
smaller  doses  of  am- 
monia and  nux  vomica. 


Animon.  carb.,  2  oz. 
Nucis  vom.,  i  oz. 
Sapo  mollis,  q.s. 

M. ;  ft.  bol.  iv. 
01.  lini,  I  pint  (liaust). 
Hypodermicaliy  :   Eseiine 
bulph.,  2  grs. 


No  treatment. 


Ammon.  carb.,  2  oz. 

Nucis  vom.,  i  oz. 

Sapo  mollis,  q.s. 

M. ;  ft.  bol.  iv. 

Spt.  ammon.  ar.\--    1 

01.  tereb.  /  ''''  ^^  °^- 

01.  lini,  I  pint. 

M. ;  ft.  haust. 

Hypodermicaliy :  Eserine 
sulph.,  2  grs. 

Injected^  hypodermicaliy, 
morphia  and  atropine, 
to  stay  excessive  action 
of  bowels  from  eserine. 

Gave  boli,  as  before. 


Sy}nJ>ioms,  Re/narks,  etc. 


Dull  pains.  No  tympany.  No  peristalsis. 
Rectum  ballooned,  and  containing  a  few 
hard,  mucus-covered  lumps. 


Slight  peristalsis.     Animal   apparently  easy, 
but  no  action  of  bowels. 


Rectum  still  empty  and  ballooned.  Peris- 
talsis quite  absent.  Usual  dull  pains. 
No  tympany.  Animal  was  quite  easy  all 
night,  but  pains  commenced  again  at 
5.30  a.m.  After  giving  the  medicines  and 
injecting  the  2  grains  of  eserine,  I  left 
the  case  until  11.40.  During  my  absence 
of  a  little  under  an  hour  the  horse  had 
evacuated  several  copious  lots  of  semi-fluid 
faices,  preceded  by  one  or  two_  mucus- 
covered  hard  quantities.  Seeing  the 
eserine  was  still  in  operation,  and  that  a 
sufficient  action  had  been  arrived  _  at,  I 
injected  an  ordinary  dose  of  morphia  and 
atropine. 

Animal  standing  up  eating  a  bran  mash  and 
apparently  comfortable.  Case  did  well 
afterwards. 


Dull  pains.  No  tympany.  No  peristalsis. 
Rectum  ballooned,  containing^  few  hard, 
mucus-covered  lumps.  Straining  attempts 
at  defEEcation  when  hand  was  introduced. 


Still  in  pain,  but  bowels  acting  freely. 


Animal  in  pain  and  peristalsis  again  in  abey- 
ance, owing  to  the  sedative.  _  Did  not  this 
time  give  eserine,  but  relied  solely  on 
ammonia  carbonate  and  nux  vomica. 

Animal  easy  and  picking  a  little  food.  Case 
afterwards  did  vNell. 


J 18  THE  COMMON  COLICS  OF  THE  HORSk 

The  stimulative  treatment  advised  in  the  foregoing 
pages  was  first  pubhshed  in  1900.  Since  then  it  has  been 
favourably  mentioned  by  Mr.  E.  R.  Harding,  M.R.C.V.S., 
of  Salisbury,  who  made  it  the  subject  of  an  address 
delivered  before  the  members  of  the  Southern  Counties 
Veterinary  ^ledical  Society  in  1901.  The  subject  of 
Mr.  Harding's  remarks  was  the  '  Treatment  of  Intestinal 
Impaction.'  For  his  words  I  am  indebted  to  the  report 
contained  in  the  Veterinary  Record.^  They  are  as 
follows  : 

*  My  reason  for  choosing  this  subject  was,  not  that  I 
have  anything  original  to  offer  you,  but  rather  the 
reverse.  It  is  to  give  you  my  experience  of  the  treat- 
ment advocated  in  a  very  able  article  by  Mr.  H.  Caulton 
Reeks,  F.R.CA^S.,  of  Spalding,  Lincolnshire,  which 
appeared  in  the  Journal  of  Comparative  Pathology  and 
Therapeutics  for  March,  1900. 

'  The  disease  is  a  common  one  to  practitioners  in 
agricultural  districts,  owing  mainly  to  the  domestic  mis- 
management of  the  farmer's  horses.  The  system  which 
prevails  in  the  district  in  which  I  practise  seems  to  be 
pretty  general.  The  horses  have  their  first  meal  about 
five  o'clock  in  the  morning.  It  consists  of  a  small  portion 
of  corn,  generally  soaked  maize ;  in  some  cases  half 
maize  and  oats.  With  this  is  mixed  a  large  quantity  of 
wheat  or  oat  hulls  or  cut  straw  chaff.  After  they  have 
been  feeding  on  this  for  an  hour  and  a  half,  they  are 
turned  out  to  drink,  then  harnessed,  and  start  for  work 
at  seven.  They  are  kept  at  it,  with  b  it  very  few  excep- 
tions, without  more  food  or  water,  until  between  three 
and  four  in  the  afternoon.  They  certainly  have  a  rest 
about  noon,  when  the  men  get  their  lunch,  but  they  have 
to  stand  in  their  harness,  mayhap,  in  the  hot  sun  or  cold 
^   Veterinary  Record,  vol.  xiv.,  p.  108. 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON    119 

wind  and  rain.  When  they  return  to  the  stable  they 
have  a  similar  large  feed  to  the  morning  one — if  anything, 
a  little  more — without  any  water  until  after  they  have 
finished.  They  are  then  turned  out  to  the  trough,  and 
we  can  imagine  the  quantity  they  drink  after  eating  such 
a  large  meal  and  working  all  day.  In  a  few  cases  nose- 
bags are  provided  for  them  at  noon,  and  on  those  farms 
"  colic  "  cases  are  not  so  frequent. 

'  The  exciting  causes,  then,  may  be  said  to  be  the  long 
intervals  between  feeding  and  the  large  amount  of  in- 
digestible food  given  them  at  each  meal. 

*  The  symptoms  of  a  subacute  case  are  those  which  do 
not  give  rise  to  any  alarm  on  the  part  of  the  owner  or 
attendants.  The  animal  looks  dull,  refuses  food,  .lies 
down  in  the  natural  position,  and  remains  quiet  for  some 
little  time,  with  the  exception,  perhaps,  of  looking  round 
to  his  flanks.  He  will  then  get  up  and  pick  a  few  mouth- 
fuls  of  straw.  After  standing  for  some  little  time,  pawing 
occasionally,  he  will  gradually  make  up  his  mind  to  lie 
down  again.  There  may  be  little  or  no  tympany,  the 
pulse,  temperature,  and  respirations  practically  normal ; 
examination  pev  rectum  will  reveal  that  bowel  to  be 
almost  empty,  while  other  portions  of  the  intestines  will 
be  found  to  be  full  of  a  mass  of  dough-like  faeces.  There 
will  be  an  entire  absence  of  abdominal  sounds.  If  relief 
be  not  afforded,  the  symptoms  will  soon  become  more 
alarming.  The  animal  will  be  up  and  down  constantly, 
and,  when  down,  rolling  ;  in  fact,  not  still  a  moment. 
The  tympany  becomes  much  greater,  and  he  breaks  out 
in  patches  of  sweat ;  pulse  and  respirations  accelerated. 
Oftentimes  we  are  too  late  to  watch  the  subacute 
symptoms,  but  on  our  arrival  the  patient  is  in  a  desperate 
condition,  perspiration  literally  pouring  from  him,  great 
tympany,  pulse  nearly  100,  respirations  much  accelerated, 


I20  THE  COMMON  COLICS  OF  THE  HORSE 

nostrils  dilated,  an  anxious  expression — in  fact,  apparently 
dying. 

'  I  should  like  here  to  quote  a  paragraph  from  Mr.  Reeks' 
article.  He  says  :  "I  cannot  lay  too  great  a  stress  on  the 
value  of  taking  the  indications  of  the  pulse,  temperature, 
and  respirations  collectively,  in  order  to  avoid  error  in 
prognosis.  I  never  look  upon  a  case  as  approaching 
dangerous  unless  I  get  a  full  warning  from  all  three." 
Then  he  refers  to  a  case  in  which  the  animal  had  been 
rolling  in  violent  pain  before  his  arrival,  but  was  then 
standing  perfectly  quiet  with  a  pulse  hammering  away  at 
io8.  But  the  temperature  was  only  loi,  and  respira- 
tions 12.     The  animal  recovered. 

'  Treatment. — In  my  younger  days  this  consisted  of 
aloes  and  opium  or  belladonna,  with  warm  water  enemas. 
This  was  successful  to  a  certain  degree,  but  there  was 
frequently  two  days'  purging.  About  twelve  or  fourteen 
years  ago  eserine  was  introduced,  and  I  have  used  it  ever 
since,  and,  with  Mr.  Reeks,  I  have  nothing  to  say  of  it 
which  is  not  in  its  favour.  But  it  is  his  nervous  stimulant 
treatment  to  which  I  wish  to  draw  your  attention.'^  I  must 
quote  from  him  again.  He  says  :  "  The  bowels,  distended 
beyond  a  certain  point,  are  retained  in  a  state  of  tonic 
cramp  in  their  ineffectual  attempts  to  deal  with  the 
enormous  masses  they  contain,  and  then  we  have  a  torpid 
and  stationary  condition  of  the  bowels  to  treat." 

'  The  treatment  he  advocates  is  a  large  dose  of  a  cerebro- 
spinal stimulant,  and  he  chooses  carbonate  of  ammonia 
and  nux  vomica.  I  must  admit  to  being  astonished  at  his 
dose,  viz.,  2  ounces  ammon.  carb.  and  i  ounce  nux  vom., 
made  into  four  balls  and  given  at  once — that  is,  to  a  big 
agricultural  horse,  with  well-marked  symptoms.  This  is 
followed  by  a  draught  consisting  of  2  ounces  of  spts. 

1  The  italics  are  mine. — H.  C.  R. 


SUBACUTE  OBSTRUCTION  OF  THE  DOUBLE  COLON     121 

tereb.  and  spts.  ammon.  arom.  and  a  pint  of  ol.  lini.  He 
repeats  the  ammon.  carb.,  substituting  pulv.  zingib.  for 
nux  vomica  in  three  to  four,  five,  or  six  hours,  if  the 
animal  is  still  in  pain,  and  in  the  meantime  gives 
frequent  hot-water  enemas.  Should  the  case  tend  to 
become  protracted,  and  the  pulse  is  strong  and  not  too 
frequent,  he  injects  hypodermically  eserine  sulph. 
I  grain,  and  if  on  the  next  visit  the  bowels  have  not 
acted,  he  gives  eserine  sulph.  2  grains,  still  continuing 
the  ammon.  carb. 

'  /  have  adopted  this  tveatinent  with  a  little  modification  with 
great  success}  The  patients  recover  much  more  quickly, 
and  without  the  nausea  and  purging  occasioned  by 
aloes.  I  at  once  inject  hypodermically  2  grains  of  eserine, 
and  give  the  dose  of  ammonia  and  nux  vomica  in  three 
balls,  and  leave  the  draught  to  be  given  in  two  hours. 
In  many  cases  this  has  effected  a  cure,  but  if  there  is  no 
improvement  in  six  or  eight  hours  I  repeat  the  ammonia 
and  sometimes  the  eserine.  If  the  horse  is  very  tym- 
panitic, I  puncture  the  bowel  with  the  trocar  and  cannula 
before  injecting  the  eserine.  In  several  cases  in  which 
the  first  dose  of  eserine  did  not  give  the  required  result 
I  have  repeated  the  2  grains  in  two  hours  with  excel- 
lent results.  /  never  give  aloes  nor  opium  now}  .  .  . 
Since  I  have  adopted  this  treatment  the  horses  get 
better  much  more  quickly.  It  used  to  be  two  or  three 
days,  but  now  I  seldom  have  a  case  last  more  than 
thirty-six  hours.' 

The  reading  of  Mr.  Harding's  paper  led  me  to  write 
asking  him  to  favour  me  with  a  short  report  of  some  of 
his  cases.  He  was  kind  enough  to  forward  the  following 
history  of  three  selected  cases  of  obstruction  : 

1  The  italics  are  mine. — H.  C.  R. 


THE  COMMON  COLICS  OF  THE  HORSE 


►5 

Dull  pains,  mostly  lying  down.     Abdomen  full, 
but  not  much  tympanj-.     No  evidence  of  peris- 
talsis.     Rectum  empty.      Small   quantities  of 
hard  faeces  had  been  pas.sed  at  short  intervals. 
Hy  nine  o'clock  a  large  quantity  of  faeces  had 
been  evacuated  ;  the  pain  more  acute  ;  sweat- 
ing   in    patches ;     respiration    hurried.       The 
chloral  was  given  to  subdue  this,  although  it  is 
the  usual  result  of  eserine  ;   but  it  was  getting 
late,  and  I  war  ted  to  get  home.     I  did  not  see 
the  horse  again. 

This   mare  was  brought  to  my  infirmary  in  an 
alarming    condition  —  sweating   and   blowing. 
I'ympany  very  great.      Peristalsis    was  soon 
much  increased  by  the  eserine,  and  much  flatus 
was  passed   at  short  intervals.     In  two  hours 
the  n)are  was  quite  easy  and  all  tympany  gone, 
and  she  was  looking  about  for  food. 

Usual  dull  pains;  little  tympany;  rectum  empty  ; 
other  bowels  full.     Eserine  induced  evacuation 
of  flatus  only.     At  three  o'clock  she  was   no 
better,    and     tj-mpanites    returning,    so    gave 
second  dose  of  eserine.     This  produced  copious 
evacuation  of  faeces,  at  first  hard,  but  quite  soft 
later.    I  left  her  at  4.30,  still  in  a  little  pain,  but 
quite  thin.     Was  told  that  she  soon  got  better 
after  I  left. 

•s 

Ammon.  carb.,  2  oz. 
Nucis  vom.,  \  oz. 
Sapo  moll.,  q"s. 
M.  ;  f.  bol.  iii. 

Also  hypodermic  dose 
of  eserine,  2  grs. 

Chloral  hyd. 
Aqua  ad  i  pint. 
M.  ;  f.  haust. 

"  6 

a, 

^'^ 

II.' 
■ill 

Ammon.  carb.,  2  oz. 
Nucis  vom  ,  h  oz. 
Sapo  moll.,  q.s. 
M.  ;  f.  bol.  iii. 

Eserine  sulph.,  2  grs., 
injected  hypo. 

Eserine  sulph  ,  2  grs., 
injected  hypo. 

^ 

1 

^ 

i 

Mixed: 

maize, 
oats,  peas, 

barley, 
and  beans ; 
cut  wheat 

straw. 

Soaked 
maize  and 

oats; 

wheat 
hulls  and 

straw. 

Soaked 
maize, 
wheat 
hulls,  and 
straw. 

111  ^^^1 

uoou  SSqV       '           1  ■••"°^  "^  '"°^V 

•Suiujoui  auius        1 
•>liOM  iv  IP  uajjuj    1 

•V  iifounfuoj 

•paparuiApqgjis  |                    -pajoafui 

•MoipA             1 

suoifv.a<fs?yf  |   2"                               1                ^ 

'>?                                1 

'3UH^             j 

»                1      11 

8                        1 

•^^l"J     \^                 1       1 

& 

10                        1 

•Soy  puv 

dti-l     1 

rt  rt  2  rt 

CJE  "  J; 

bH      ' 

&                          a,      1 

«i 

-i         4 

•^'^^         |8                              Jd,                ||jj. 

•^^^J                  "                                                            N                                   1    ro 

CHAPTER  X 

SUBACUTE  OBSTRUCTION  OF  THE 

PELVIC  FLEXURE  OF  THE 

DOUBLE  COLON 

Definition. — So  long  as  the  full  wording  of  this  chapter 
heading  is  adhered  to,  no  definition  will  be  needed.  It 
sufficiently  explains  itself. 

On  reference  to  p.  8i  it  will  be  seen  that  the  preceding 
chapter  is  '  given  over  to  all  obstructions  of  a  subacute 
type  that  occur  in  any  position  in  the  large  or  double 
colon.'  No  attempt  is  made  there  to  indicate  any  special 
seat  of  trouble,  or  to  single  out  any  particular  portion  of 
the  colon's  course  as  calling  for  more  than  ordinary 
mention.  At  the  time  when  that  was  written — namely, 
in  1902— I  did  not  feel  that  I  had  anything  sufficiently 
clear  in  the  shape  of  a  differential  diagnosis  to  offer. 
Nevertheless,  it  will  be  noticed  that,  even  then,  I 
indicated,  if  only  vaguely,  that  such  might  be  furnished 
by  fuller  investigation. 

Since  that  time,  a  record  of  several  cases,  together 
with  the  evidence  gathered  during  post-mortems  of  twist 
of  the  double  colon,  has  shown  me  that  often  we  have  a 
form  of  obstruction  mainly,  if  not  entirely,  confined  to 
the  pelvic  flexure  of  that  bowel.  It  has  shown  me,  too, 
that  quite  often  the  condition  may  be  diagnosed,  and  the 

123 


114 


THE  COMMON  COLICS  OF  THE  HORSE 


exact  nature  of  the  case  explained  to  the  owner.  If  only 
for  this  last  reason,  seeing  the  added  reputation  it  gives 
to  the  veterinarian,  it  merits  recording. 


Fig.  8. — The  Normal  Colon  exposed,  and  its  Pelvic 
Flexure  drawn  out  from  the  Abdomen. 

I,  2,  3,  and  4,  The  first,  second,  third,  and  fourth  portions, 
respectively,  of  the  bowel  ;  5,  the  pelvic  flexure. 

Causes. — Putting  on  one  side  the  causes  of  colic 
generally,  merely  referring  the  reader  to  Chapters  IV. 
and  v.,  we  shall  still  find  one  or  two  reasons  why 
obstruction  should   be  specially  prone  to  occur  at  the 


SUBACUTE  OBSTRUCTION  OF  THE  PELVIC  FLEXURE   125 

point  with  which  we  are  dealing.  We  shall  find  these 
in  the  anatomical  arrangement  and  distribution  of  this 
portion  of  the  colon. 

The  first  point  of  importance  is  the  fact  that  in  this 
position  there  is  a  somewhat  marked  constriction  in  the 
lumen  of  the  gut.  Considering  the  two  portions  of  the 
colon  forming  the  flexure — namely,  the  second  and  the 
third — we  see  at  once  that  while  the  second  portion,  from 
the  suprasternal  flexure  backwards,  is  of  considerable 
size,  the  third  is  comparatively  small. 

Further,  we  notice  that  the  diminution  in  lumen  is 
not  gradual,  but  that  it  occurs  with  some  degree  of 
suddenness,  thus  occasioning  the  constriction  referred  to. 
A  glance  at  Fig.  8  will  explain. 

It  needs  no  great  amount  of  demonstration  to  point 
out  that  the  circumference  of  the  bowel  taken  around  the 
second  portion  at  a  point  indicated  by  the  dotted  line  a  h, 
is  distinctly  larger  than  when  taken  around  the  pelvic 
flexure  at  c  d.  This,  as  a  matter  of  fact,  is  more  evident 
with  the  actual  bowel  before  one  than  with  merely  the 
photograph  to  refer  to.  It  is  distinctly  more  marked, 
too,  in  an  animal  that  has  been  taking  a  normal  amount 
of  food.  In  the  case  from  which  this  illustration  was 
taken  the  animal  had  died  from  a  wasting  disease,  and 
the  bowels  were  comparatively  empty. 

In  so  much  as  that  to  some  extent  it  exaggerates  this 
difference  in  size  between  the  second  and  the  third 
portions  of  the  colon.  Fig.  9  will  more  clearly  illustrate  it. 

This  is  a  photograph  of  one  of  the  several  cases  of 
twist  of  the  pelvic  flexure  that  have  come  under  my 
notice.  Here,  owdng  to  the  displacement  of  the  bowel, 
the  ingesta  is  prevented  from  passing  out  of  the  second 
portion  of  the  bowel  into  the  third.  The  second  portion 
is  therefore  shown  distended  to  the  full  with  accumulated 


T26  THE  COMMON  COLICS  OF  THE  HORSE 

ingesta,  while  the  third  is  nearly  empty.  In  this  manner 
the  abrupt  transition  from  the  bulky  and  voluminous 
form  of  the  second  portion  to  the  small  and  comparatively 
shrunken  build  of  the  third  portion  is  accentuated.     In 


Fig.  9. — Volvulus  or  Twist  of  the  Pelvic  Flexure  of  the 
Large    Colon,    illustrating    the    Difference    in    Size 

BETWEEN   THE    SECOND  AND   ThIRD   PORTIONS   OF   THE   BoWEL. 

I,  2,  and  3,  The  first,  second,  and  third  portions,  respectively,  of  the 
bowel.     Note. — The  fourth  portion  is  hidden  from  sight. 

such  a  case  as  this  it  might  be  that  either  the  accumu- 
lated faecal  matter  in  the  end  of  the  second  portion,  by 
reason  of  cramp-like  efforts  on  the  part  of  the  bowel  to 
pass  it  along,  was  responsible  for  the  twist,  or  that  the 


SUBACUTE  OBSTRUCTION  OF  THE  PELVIC  FLEXURE  127 

twist  itself  was  accountable  for  the  engorgement  of  the 
distended  second  portion  of  the  bowel.  Of  that  I  may 
have  more  to  say  at  some  future  date.  It  is  sufficient 
now  if  it  serves  to  point  out  the  difference  in  size  of 
these  two  sections  of  the  colon,  and  the  special  liability 
of  this  portion  of  the  intestinal  tract  to  trouble  accruing 
from  obstruction. 

In  order  to  make  this  point  quite  clear,  I  insert  here  a 
further  photograph  of  the  same  case  of  twist  (see  Fig.  10). 


Fig.  10.— Volvulus  of  the  Pelvic  Flexure  of  the  Colon  — 
THE  Colon  pulled  out  from  the  Abdomen  and  extended. 

I,  The  pelvic  flexure  of  the  bowel  ;  2,  the  second  portion  ; 
and  3,  the  third  portion  of  the  bowel. 

Here  we  have  the  suprasternal  and  diaphragmatic 
flexures  obliterated  by  removing  the  colon  from  the  body 
and  drawing  it  out  to  its  full  length.  The  marked 
difference  in  size  of  the  two  portions  of  the  bowel  we  are 
considering  is  then  made  quite  apparent.  Portion 
number   three,    nearly   empty,  lying   beneath  the  over- 


128  THE  COMMON  COLICS  OF  THE  HORSE 

charged  portion  number  two,  looks  small  almost  to  the 
point  of  being  shrunken. 

A  further  anatomical  fact  of  importance  to  be  noted  in 
this  connection  is  that  a  portion  of  bowel  with  such  an 
abrupt  turn  in  it  as  this  pelvic  flexure  should  have  so 
free  a  distribution  in  the  abdomen.  We  have  here  a 
bowel  several  feet  in  length,  of  voluminous  build,  and 
designed  to  carry  enormous  weights  of  ingesta,  with  a 
heavy  and  unattached  end.  Devoid  of  mesenteric  or 
other  stay  to  hold  it  in  position,  this  heavy  end  is  free  to 
move  at  will  in  the  abdomen.  This  must,  one  would 
think,  lead  at  times  to  troubles  which  could  easily  be  re- 
ferred to  slight  displacement.  One  could  easily  imagine, 
for  instance,  that  displacement,  similar  to  that  depicted 
in  Fig.  lo,  though  less  in  degree,  would  be  able  to  occur 
to  the  point  of  engendering  a  troublesome  case  of  obstruc- 
tion, without  leading  to  actual  twist,  or  causing  the 
animal's  death.  At  any  rate,  it  is  astonishing  how  often 
in  cases  of  obstructive  colic  one  is  able  to  feel  pey  rectum 
this  particular  portion  of  the  intestinal  tract  quite  plainly 
in  a  state  of  dangerous  engorgement. 

Again,  though  to  some  extent  it  may  be  labouring  the 
point,  I  think  another  reason  for  tendency  to  obstruction 
at  this  particular  spot  may  be  found  in  a  physiological 
explanation.  Comparable  to  the  sluggishness  of  the 
circulation  in  the  distal  end  of  a  limb,  we  may  take  it 
that  the  force  of  the  blood-supply  at  the  pelvic  flexure  is 
not  so  great  as  elsewhere  in  the  bowel.  It  is,  of  course, 
at  the  extreme  end  of  both  the  direct  and  retrograde 
colic  arteries ;  and  if  stasis  of  the  bowel  wall  is  ever  due 
to  imperfect  circulation,  which  in  other  portions  of  this 
work  we  have  admitted  it  is,  then  one  would  quite 
expect  to  find  the  pelvic  flexure  one  of  the  seats  of 
trouble  when  such  cause  is  in  operation. 


SUBACUTE  OBSTRUCTION  OF  THE  PELVIC  FLEXURE 


129 


As  a  matter  of  fact,  cases  that  occur  in  practice  bear 
out  this  latter  contention.  More  often  than  not  the 
subject  of  subacute  obstruction  of  the  pelvic  flexure  is  an 
aged  animal.  Several  other  causes,  it  is  true,  have  at 
the  same  time  to  be  reckoned  with.  Imperfectly  masti- 
cated food,  growing  diminution  in  the  proper  secretion 
of  gastric  and  intestinal  fluids,  and  the  gradual  lessening 
in  nerve  force  consequent  on  senility,  all  play  a  part  in 
determining  an  attack  of  obstruction  in  a  bowel  so 
voluminous  in  extent  and  so  peculiar  in  build  as  the 
double  colon  of  the  horse.  Add  to  these  facts  the 
further  reasons  that  I  have  here  endeavoured  to  explain, 
and  it  will  be  seen  that  obstruction  of  the  pelvic  flexure 
is  quite  often  a  thing  to  be  looked  for. 

In  conclusion,  I  may  add  that  I  have  not  yet  met  with 
a  case  of  this  description  in  a  nag  animal.  It  appears 
mainly  to  occur  in  animals  of  a  heavy  and  lymphatic 
type,  owing  partly,  perhaps,  to  the  larger  size  of  the 
colon,  but  more  certainly  to  the  grosser  manner  in 
which  some  of  these  animals  are  fed. 

Symptoms. — Again  the  general  symptoms  of  subacute 
obstruction  of  the  colon,  as  detailed  in  Chapter  IX.,  are 
to  be  expected.  To  those  I  have  nothing  to  add.  There 
are,  however,  one  or  two  points  concerning  them  that  in 
this  particular  connection  require  to  be  dwelt  on. 

Quite  a  prominent  feature  in  a  case  of  pelvic  obstruc- 
tion is  the  '  dull '  character  of  the  pains,  which  dulness 
has  for  so  long  been  associated  with  impaction  of  the 
colon.  Although  at  times  there  is  evidence  of  restless- 
ness, a  troubled  walk  round  the  box,  anxious  looks  round 
at  the  flank,  and  patchy  perspirations,  the  animal  is  able 
to  remain  for  the  greater  part  of  the  time  in  a  comfort- 
able stretched-out  position  on  the  floor.  In  this  manner 
rest  is  often  taken  for  long  periods  at  a  time.     Save  for 

9 


I30  THE  COMMON  COLICS  OF  THE  HORSE 

the  fact  that  occasionally  the  head  is  lifted,  while  the 
animal  stares  with  what  might  best  be  termed  a 
*  puzzled  '  expression  into  his  flank,  the  ordinary  looker- 
on  would  see  nothing  very  untoward. 

The  pulse,  taken  at  these  times,  is  always  reassuring 
to  the  veterinary  attendant.  In  so  far  as  the  number  oi 
its  beats  is  concerned,  it  is  little,  if  any,  disturbed  from 
the  normal.  It  is  firm  and  full  to  the  fingers,  and  in  no 
way  at  all  offers  suggestion  of  anything  grave. 

Called  in  at  such  a  moment  as  this,  the  veterinary 
surgeon,  unless  he  methodically  makes  a  rectal  examina- 
tion in  every  case  of  colic  he  attends,  may  dismiss  the 
case  rather  lightly.  He  will  simply  administer  the  usual 
dose  of  aperient  medicine  and  such  other  remedies  as  he 
deems  the  case  necessitates,  probably  concluding  by 
suggesting  to  the  owner  that  a  further  visit  will  be 
unnecessary — that  a  few  hours  hence  will  see  the  end  of 
the  trouble. 

In  such  a  case  as  I  am  describing,  however,  he  wdll 
most  certainly  be  called  in  again.  This  time  he  may  be 
fortunate  enough  to  find  his  patient  in  one  of  the  periods 
of  unrest.  The  pulse  is  then  plainly  disturbed.  Flutter- 
ing and  irregular,  and  accelerated  in  number  of  beats,  it 
is  plainly  indicating  that  some  more  serious  condition 
than  at  first  the  surgeon  suspected  is  in  existence.  Patchy 
perspirations  bedew  the  body,  and  the  respirations  become 
quickened  in  number. 

At  this  point  the  veterinary  surgeon  may  be  informed 
that  since  his  last  visit  the  patient  has  passed  several 
different  lots  of  faeces.  In  no  great  quantity  at  one  time, 
he  is  told,  but  in  quite  little  lots.  Led  to  it  by  further 
questioning,  the  owner  also  informs  him  that  even  prior 
to  the  time  of  his  first  visit  this  has  been  going  on.  The 
veterinary  surgeon  is  thus  brought  up  against  the  fact 


SUBACUTE  OBSTRUCTION  OF  THE  PELVIC  FLEXURE    131 

that,  if  only  in  separately  small  quantities,  some  con- 
siderable amount  of  faeces,  when  taken  in  the  bulk,  has 
been  expelled,  and  this,  too,  during  such  time  as  the 
animal  has  plainly  been  suffering  from  obstruction. 

If  he  has  not  already  done  so,  he  is  led  at  this  stage 
to  explore  the  rectum.  He  finds  it  empty,  open,  and 
ballooned.  He  finds  further  that,  within  easy  reach  of 
his  arm,  his  hand  comes  into  contact  with  a  portion  of 
impacted  intestine  of  considerable  size,  which  leads  him 
at  once  to  a  correct  understanding  of  his  case. 

Diagnosis. — This  is  arrived  at  by  further  manipula- 
tion of  the  impacted  bowel.  The  surgeon  finds  that, 
although  larger  in  size,  and  probably  not  so  angular,  it  is 
comparable  in  shape  to  the  flexed  knee  of  a  man  pushed 
there  towards  him.  What  he  is  feeling  is  the  impacted 
pelvic  flexure.  That  at  its  point  of  constriction  (see 
where  the'  number  5  is  placed  on  Fig.  8)  represents  the 
knee  ;  and  the  surgeon,  passing  from  one  side  to  the 
other  of  this  central  point,  makes  out  with  the  flat  of  his 
hand  the  rounded  and  engorged  portions  of  the  bowel, 
which,  to  heighten  the  rough  simile  he  has  already 
framed,  he  may  compare  to  the  calf  and  the  thigh  of  the 
flexed  imaginary  limb. 

In  other  cases,  according  to  the  position  the  impacted 
bowel  has  taken  up,  it  suggests  to  the  exploring  hand 
the  further  simile  of  a  partly  developed  foetus.  This  is 
the  more  noticeable  when,  by  reason  of  its  increased  size 
or  other  cause,  the  whole  thing  has  taken  up  a  more 
central  position  than  is  normal. 

As  to  the  nature  of  the  contents,  these  are  quite  hard, 
and  can  only  with  difliculty  be  indented  with  the  fingers 
pressing  on  them. 

Inasmuch  as  that  in  the  following  chapter  I  shall  deal 
with  a  further  form  of  obstruction  which  may  also  be 

9—2 


132  THE  COMMON  COLICS  OF  THE  HORSE 

felt  per  rectum — namely,  obstruction  of  the  single  colon — 
it  is  necessary  at  this  point  to  show  means  of  differentia- 
tion. A  reference  to  that  chapter  will  show  that  in  the 
condition  there  described  we  have  a  set  of  general 
symptoms  far  more  alarming.  There  is  continuous  pain, 
an  always  troubled  state  of  the  pulse,  a  tendency  to  stand 
in  a  stretched-out  position,  with  ejected  penis  and  quiver- 
ing tail,  and  a  gradual  increase  in  the  severity  of  the 
pains  unless  the  condition  is  soon  relieved.  Also  we 
have  violent  straining  attempts  at  defaecation  and  a 
clinging  grasp  of  the  rectum  on  the  inserted  arm, 
together  with  a  violently  expulsive  action  of  the  bowel, 
called  forth  at  once  by  anything  inserted  therein. 

Without  committing  myself  to  the  statement  that  none 
of  these  symptoms  are  ever  witnessed  in  a  case  of 
obstruction  of  the  pelvic  flexure,  I  can  unhesitatingly 
declare  that  they  are  never  marked.  I  can  further 
assure  the  reader  that  in  no  instance  will  more  than  one 
or  two  of  these  more  serious  signs  be  seen  at  one  and 
the  same  time. 

So  far  as  he  is  yet  able  to  sum  up  his  case,  the 
veterinarian  is  now  confident  that  he  has  before  him  a 
case  of  obstruction  implicating  to  a  grave  extent  the 
pelvic  flexure  of  the  colon,  and  he  is  able  to  read  at  its 
full  value  a  symptom  that  until  now  may  have  been 
somewhat  puzzling.  I  refer  to  the  constant  evacuation 
of  small  quantities  of  faeces.  It  appears  now  that  the 
single  colon,  and  also  the  third  and  fourth  portions  of  the 
double  colon,  have,  in  irritable  manner,  been  discharging 
their  contents.  It  appears,  further,  that  nothing  now 
remains  to  hinder  the  normal  evacuation  of  the  contents 
of  the  rest  of  the  intestinal  tract  save  the  obstruction  at 
the  pelvic  flexure. 

One   other   point    has   yet   to   be   decided   before  his 


SUBACUTE  OBSTRUCTION  OF  THE  PELVIC  FLEXURE   133 

diagnosis  is  complete.  Is  there  or  is  there  not  displace- 
ment of  the  bowel  to  the  extent  of  actual  twist  ?  Although 
for  some  years  I  have  been  looking  for  it,  I  cannot  yet 
say  definitely  that  I  have  been  able  to  detect  any  pecu- 
liarity, either  in  the  shape  or  in  the  distribution  of  the 
bowel  that  I  can  put  down  as  diagnostic.  So  far,  how- 
ever, as  my  knowledge  of  these  cases  at  present  goes,  I 
am  of  the  opinion  that  in  nearly  every  instance  where 
this  knee-shaped  and  ingesta-packed  piece  of  bowel  is 
present  in  the  pelvis  it  may  be  taken  as  certain  that  twist 
has  not  occurred.  My  reason  for  advancing  this  opinion 
is  that  in  nearly  every  case  of  volvulus  of  the  large  colon, 
the  diagnosis  of  which  I  have  afterwards  verified  at  post- 
mortem, the  pelvic  flexure  is  displaced  to  the  extent  of 
removing  it  from  reach  by  way  of  the  rectum. 

Prognosis. — In  face  of  the  opinion  I  have  offered, 
that  once  this  condition  is  diagnosed  volvulus  is  unlikely 
to  be  in  existence,  I  still  advise  that  only  a  guarded 
prognosis  should  be  given.  It  may  be  that  further  inves- 
tigation still  will  reveal  the  fact  that  such  a  condition  as 
this  may  occur  concomitantly  with  twist.  This  advice, 
however,  applies  only  to  that  occasion  on  which  during 
his  visits  the  surgeon  is  first  aware  of  the  exact  nature  of 
his  case.  He  should  then  explain  to  the  owner  exactly 
what  he  is  dealing  with,^  tell  him  that  relief  will  certainly 
not  be  obtained  for  several  hours,  and,  finally,  if  only 
to  protect  himself  against  contingencies,  suggest  the 
possibility  of  twist. 

After  this,  should  his  next  visits  find  the  pulse  still 
near  the  normal,  and   his   patient   still   exhibiting   long 

1  I  have  found  that  a  very  convenient  method  of  doing  this  is  to 
lay  out  on  the  floor  an  ordinary  roller-towel,  doubled  in  such  a  way 
as  to  represent  nearly  the  course  of  the  double  colon  in  the  abdomen. 
— H.  C.  R. 


134  TTHE  COMMON  COLICS  OF  THE  HORSE 

periods  of  freedom  from  acute  pain,  he  may,  notwith- 
standing the  fact  that  somewhat  alarming  paroxysms 
occur  at  intervals,  indulge  in  a  more  favourable  forecast. 
Such  paroxysms  as  then  occur  may  be  taken  as  evidence 
that  the  bowel  is  attempting  to  deal  with  the  adverse 
circumstances  under  which  it  is  placed.  In  other  words, 
it  is  but  a  sign  that  the  administered  purgative  is  acting, 
and  that  the  obstruction  is  being  moved. 

Treatment. — In  no  particular  does  this  offer  any 
special  difficulty.  It  is  quite  evident,  even  from  the 
commencement  of  the  case,  that  what  we  have  to  treat 
is  a  torpid  condition  of  the  bowel  wall.  After  what  I 
have  written  in  the  previous  chapter,  therefore,  I  need 
hardly  say  that,  whatever  else  we  do,  we  should  carefully 
abstain  from  the  use  of  sedatives.  They  can  but  render 
worse  what  is  already  a  sufficiently  bad  case.  Instead,  I 
again  advise  the  exhibition  of  stimulants,  and,  in  such  a 
case  as  this,  we  are  wise  if  we  suggest  their  administration 
at  very  frequent  intervals.  The  balls  of  ammonium 
carbonate  and  nux  vomica  may,  therefore,  be  given  as 
before,  and  followed  up  at  intervals  of  a  few  hours  with 
other  balls  of  ammonium  carbonate,  combined  this  time 
with  zingib.  rad  pulv.  instead  of  the  nux  vomica. 

Quite  early  in  the  case  a  reliable  purgative  should  be 
administered.  This  may  be  either  full  doses  of  linseed 
oil,  or  an  aloetic  ball  of  medium  strength.  Regarding 
the  latter,  I  have  found  that  6  drams  is  a  suitable  dose 
for  a  large  cart  animal,  while  to  a  nag  I  make  a  practice 
of  giving  somewhat  less.  All  we  have  to  bear  in  mind 
in  this  connection  is  that  the  dose  shall  be  such  as  to 
allow  of  a  vigorous  stimulant  treatment  being  afterwards 
maintained  without  risk  of  superpurgation. 

While  busy  with  the  treatment,  it  is  well  for  the 
practitioner  to  mention  to  the  owner  the  fact  that  in  this 


SUBACUTE  OBSTRUCTION  OF  THE  PEL  VIC  FLEXURE   135 

particular  form  of  colic  speedy  relief  need  not  be  looked 
for.  Quite  confidently  he  may  predict  that  some  eighteen 
to  twenty-four  hours  must  elapse  after  administration  of 
the  purgative  before  cessation  of  the  pains  may  be  ex- 
pected. 

Should  the  case  linger  longer  than  this,  which  in  an 
aged  animal  it  is  very  apt  to  do,  I  have  found  the  patient 
to  derive  great  benefit  indeed  from  hypodermic  doses  of 
ether,  given  in  sufficiently  large  doses  to  maintain  the 
flagging  energies  of  the  heart.  It  is  astonishing  how 
soon  the  drug,  administered  in  this  way,  exerts  its  effects. 
The  irregular  circulation  is  almost  immediately  equalized; 
the  pulse  becomes  somewhat  slower,  but  stronger  and 
fuller;  and  at  the  same  time  action  of  the  bowels  is 
certainly  promoted.  In  fact,  the  best  way  in  which  one 
can  sum  up  its  effects  is  to  use  the  comprehensive 
expression  that  it  *  gives  tone '  to  the  system  generally. 

Next,  as  to  the  administration  of  eserine.  So  far  as 
my  own  experience  goes,  I  may  say  at  once  that  in 
obstruction  of  the  pelvic  flexure  I  have  found  it  unwise 
to  exhibit  this  drug  in  the  early  stages  of  the  case.  Had 
that  not  been  so,  I  should  have  mentioned  it  before. 
We  have  here  an  obstruction  within  easy  reach  of  the 
hand,  the  changes  in  the  consistency  of  which  can  be 
noted  hourly ;  and  it  seems  a  far  more  desirable  thing, 
to  my  mind,  to  wait  until  the  administered  medicines 
have  effected  some  degree  of  softening  therein  before  we 
push  the  bowel  to  extreme  efforts  to  dislodge  it.  Given 
earlier,  it  is  productive  of  acute  pain,  and  with  no  bene- 
ficial result,  so  far  as  one  can  see,  to  the  patient. 
Directly,  however,  one  is  able  to  detect  some  tendency 
on  the  part  of  the  obstruction  towards  softening  down, 
then  the  eserine  may  be  administered  with  the  happiest 
results. 


136  THE  COMMON  COLICS  OF  THE  HORSE 

One  further  point  in  the  treatment  and  I  have  done. 
It  is  important,  however.  On  no  account  should  the 
constant  throwing  into  the  rectum  of  warm  enemata  be 
neglected.  I  had  almost  said  they  should  be  *  hot.'  At 
any  rate,  they  should  be  as  near  that  as  prudence  directs. 
The  rectum  is  ballooned,  and  fluid  thrown  in  is  retained 
some  little  while.  Although  not  in  actual  contact  with 
the  obstruction  itself,  such  fluid  occupies  as  nearly  that 
position  as  one  could  wish,  only  the  thin  walls  of  the 
rectum  and  the  colon  lying  between  it  and  the  offending 
substance.  I  am  unaware  of  any  proved  process  by 
which  such  fluid  may  percolate  through  or  become 
absorbed.  It  certainly  appears,  however,  that  some 
such  process  is  in  operation,  or  that  the  continual 
application  of  warmth  by  this  means  to  the  wall  of  the 
colon  excites  it  to  increased  secretion.  At  any  rate,  the 
obstruction  is  slowly  but  plainly  softened.^ 

To  do  good,  these  enemata  must  be  frequent.  Hourly 
injections  are  not  at  all  too  frequent.  Far  from  irritating 
the  patient,  as  one  might  perhaps  expect,  they  appear  to 
exert  a  soothing  influence,  and  play  a  safe  and  effectual 
part  in  bringing  about  resolution. 

^  See  here  also  Chapter  XIII.,  on  'Intestinal  Irrigation  in 
Obstructions  of  the  Colon,'  and  refer  to  the  case  on  page  169. 


CHAPTER  XI 

SUBACUTE   OBSTRUCTION   OF   THE 
SINGLE  COLON 

Definition. — Obstruction  or  stoppage  of  a  subacute  type 
occurring  in  the  single  or  floating  colon,  or  in  the  rectum. 
For  my  purpose  in  this  chapter  I  have  considered  the 
rectum  as,  what  it  really  is.  the  last  portion  of  the  small 
colon,  and  shall  therefore  refer  to  rectal  impaction  under 
this  heading. 

Causes. — Without  referring  the  reader  to  any  general 
cause  other  than  those  already  mentioned  in  Chapters  IV., 
v.,  and  IX.,  I  would  ask  him  to  remember  one  or  two 
peculiar  to  this  disorder  only.  Anatomically  the  build, 
and  physiologically  the  function,  of  the  floating  colon 
offer  two  fairly  powerful  predisposing  incentives  to 
obstruction,  and  that  of  a  rather  dangerous  type. 

Firstly,  the  sacculated  nature  of  this  viscus  is  such 
that  it  compresses  the  faecal  matters  into  rounded  or 
oval-shaped  masses,  peculiarly  fitted  to  form  obstructive 
lumps  when  other  causes  favouring  impaction  concur. 

Secondly,  the  function  of  this  intestine  is  largely  to 
complete  the  absorption  of  the  fluid  matters  of  the  ali- 
ment, and  we  may  easily  understand,  when  this  absorp- 
tion of  fluid  is  carried  on  to  an  abnormal  extent  (as,  to 
offer  a  simple  instance,  in  a  case  of  acute  and  prolonged 


138  THE  COMMON  COLICS  OF  THE  HORSE 

febrile  disturbance),  how  that  the  accumulated  lumps  of 
faecal  matter  become  so  hardened  by  the  withdrawal  of 
moisture  as  to  seriously  prejudice  their  chance  of  effectual 
displacement  by  normal  intestinal  movements. 

Also,  regarding  this  portion  of  the  intestinal  tract, 
some  little  attention  should  be  paid  to  the  consideration 
of  nervous  trouble  as  a  primary  cause.  I  do  not  wish 
the  reader  to  imagine  anything  obscure  in  its  nature  or 
of  comparatively  rare  occurrence.  It  is  something  quite 
simple  to  understand,  and  of  more  or  less  every-day 
happening.  Everyone  is  aware  of  the  fact  that  a  nerve 
is  paralyzed — its  function  temporarily  inhibited — by  being 
in  contact  with  an  overworked  or  tired  muscle,  a  muscle 
that  is  impregnated  with  effete  materials  that  its  long 
continuing  work  has  left  it  too  fatigued  to  rid  itself  of. 
It  may  be,  perhaps  out  of  sympathy,  perhaps  by  a 
process  of  absorption  whereby  it  takes  up  a  certain 
amount  of  the  poisonous  muscle  waste,  that  nerves  or 
nerve-centres  in  close  apposition  with  such  overworked 
muscles  become  paralyzed,  and  fail  temporarily  to  per- 
form their  proper  function. 

In  this  manner  the  posterior  mesenteric  plexus  (formed 
in  great  part  by  the  lumbar  portion  of  the  great  sym- 
pathetic system,  and  furnishing  branches  for  the  supply 
of  the  small  colon  and  the  rectum)  may  often  be  so 
induced  to  a  state  of  dangerous  lethargy.  The  lumbar 
portion  of  the  sympathetic,  lying  as  it  does  in  close  con- 
tact with  the  psoae  muscles,  and  being  largely  covered  by 
the  posterior  vena  cava,  would  be  almost  the  first  nerve- 
centre  supplying  the  intestinal  tract  to  feel  the  ill  effects 
of  the  waste  materials  from  the  muscles  of  the  hind 
limbs  and  the  loins.  At  any  rate,  whatever  the  explana- 
tion may  be,  it  is  certain  that  prolonged  and  excessive 
work,  especially  that  of  a  heavy  hauling  nature,  telling 


SUBACUTE  OBSTRUCTION  OF  THE  SINGLE  COLON     139 

principally  on  the  muscles  of  the  lumbar  region,  has  a 
peculiar  depressive  action -on  the  urinary  apparatus  and 
the  last  portions  of  the  bowels — a  depressive  action  that 
effectually  tends  to  a  torpid  and  stationary  condition  of 
the  bowel  contents. 

We  are  not  to  be  greatly  surprised,  then,  that  the 
effects  of  a  long  day's  heavy  carting  are  likely,  from  a 
constipating  point,  to  settle  themselves  in  the  small 
colon  or  rectum. 

Apart  from  this  temporary  derangement  of  the  nervous 
system,  the  practitioner  will  occasionally — very  occasion- 
ally— meet  with  cases  of  total  paralysis  of  the  rectal  walls, 
which,  until  noticed  and  correctly  treated,  will  again  lead 
to  subacute  obstruction. 

Symptoms. — All  the  usual  symptoms  of  colic  will  be 
found  in  evidence  here.  There  is  the  usual  getting  up 
and  down,  the  anxious  looks  round  to  the  flank,  the 
patchy  perspirations,  and  the  common  changes  in  the 
temperature  and  respirations.  The  pulse,  almost  from 
the  very  commencement  of  the  case,  is  weak,  or,  rather, 
undecided,  in  character,  at  one  moment  filling  the  artery 
to  a  comfortable  firmness,  at  another  dwindling  down  to 
an  indistinctness  nearing  the  imperceptible.  This  may 
all  occur  within  a  few  seconds  and  during  one  observa- 
tion, and  its  number  of  beats  will  vary  from  70  to  80  or 
90  per  minute. 

Com.pared  with  the  other  two  forms  of  obstructive 
colic,  there  is  not  that  period  of  total  ease  so  frequently 
occurring  between  the  paroxysms  of  pain.  In  obstruc- 
tion of  the  double  colon,  for  instance,  we  commonly 
have  periods  of  ease  in  which  the  pulse  drops  to  a 
normal  condition,  both  regarding  its  tone  and  number 
of  beats. 

In  obstructions  of   the    single   colon    that   seldom  or 


I40  THE  COMMON  COLICS  OF  THE  HORSE 

never  occurs.  What  does  happen,  however,  is  so  mis- 
leading to  the  casual  observer  and  of  such  importance  to 
the  careful  inquirer  as  to  merit  special  attention.  The 
patient,  certainly  for  some  few  minutes,  will  stand,  to 
outward  appearances,  quiet.  If  the  judgment  is  hurried, 
this  will  be  confused  with  the  usual  period  of  ease  in 
ordinary  colic.  The  case  will  be  dismissed  as  '  nothing 
dangerous.'  The  pulse  tells  a  different  tale.  It  is  still 
maintaining  a  troubled,  fluttering  beat  of  70  to  80,  and  is 
evidence  enough  of  serious  conditions  within.  The  con- 
junctiva is  reddened,  though  not  to  such  a  degree  as  the 
continuous  pains  would  at  first  appear  to  point  to,  while 
the  perspirations  mentioned  above  do  not  incline  to 
become  cold  or  clammy. 

If  not  relieved,  towards  the  end  of  the  first  twelve 
hours  the  animal  shows  more  or  less  tendency  to  stand 
in  a  stretched-out  condition,  as  though  attempting  to 
urinate.  The  marked  frequency  with  which  this  stretch- 
ing occurs  in  this  form  of  colic  is  a  warrant  sufficient  for 
pointing  it  out  as  a  special  symptom. 

Later,  the  periods  of  apparent  ease  become  fewer  and 
farther  between,  and  the  animal  is  in  more  or  less 
constant  pain.  Another  symptom,  frequent  to  a  point 
approaching  the  diagnostic,  is  violent  straining,  which  is 
persisted  in  with  such  force  as  to  move  the  onlookers  to 
fear  for  the  patient's  safety.  During  the  straining  the 
patient  emits  a  series  of  painful  groans,  and  the  mucous 
lining  of  the  rectum  is  often  everted  to"  the  extent  of 
several  inches.  If  a  mare,  and  especially  if  she  be  with 
foal,  the  vulva  is  in  like  manner  everted,  and  the  pains 
sometimes  of  such  a  severity  as  to  suggest  the  act  of 
foaling. 

The  hand  inserted  in  the  rectum  is  met  by  a  violent 
expulsive  action  of  the  bowel,  accompanied  by  straining 


SUBACUTE  OBSTRUCTION  OF  THE  SINGLE  COLON     14^ 

efforts  on  the  part  of  the  patient,  while  the  bowel  itself 
exerts  a  peculiar  glove-like,  clasp  upon  the  arm. 

The  pelvis  is  found  to  contain  portions  of  bowel  beyond 
its  normal  contents  :  if  small  intestines,  empty  ;  if  single 
colon,  more  or  less  impacted  with  ingesta.  Sometimes 
it  fortunately  happens  that  the  very  portion  of  bowel 
giving  rise  to  the  trouble  is  well  within  reach  of  the 
operator's  arm.  If  so,  no  further  doubt  as  to  the  exact 
nature  of  the  case  he  is  treating  need  remain  in  his  mind. 

In  different  cases  the  obstructed  bowel  varies  in  shape 
and  size  from  a  small  portion  resembling  a  large  cocoa- 
nut  to  an  impacted  length  of  from  6  to  12  inches.  That 
this  impacted  portion  is  the  actual  cause  of  trouble  is 
fairly  evidenced  by  the  symptoms  induced  by  its  manipu- 
lation. Pressure  on  it,  even  if  of  a  careful  and  tentative 
nature,  will  cause  the  patient  to  evince  unmistakable 
signs  of  pain.  Swerving  from  side  to  side,  he  endeavours 
to  escape  the  inserted  arm ;  and,  persisted  in,  the 
manipulative  movements  will  bring  him  with  successive 
crouching  gestures  to  the  ground. 

In  most  cases,  contrary  to  what  one  would  imagine, 
tympany  is  absent ;  and  it  is  only  towards  the  end  of  the 
attack,  when  the  case  is  approaching  a  fatal  termination, 
that  it  occurs  to  any  appreciable  extent.  Enemas  intro- 
duced with  a  nozzle  of  ordinary  length  are  not  retained, 
but  forcibly  ejected  almost  immediately  after  their  in- 
jection. 

Should  the  case  be  one  of  rectal  impaction,  its  nature 
will  at  once  be  apparent  directly  the  hand  is  introduced 
into  the  rectum  ;  and,  so  far  as  the  purposes  of  this 
chapter  are  concerned,  a  consideration  of  its  other 
symptoms  is  unnecessary.  Provided  the  animal  is 
healthily  strong  prior  to  the  attack,  and  his  end  is  not 
hastened  by  the  exhibition  of  sedatives  or  violent  purga- 


142  THE  COMMON  COLICS  OF  THE  HORSE 

tives,  the  case  is  of  a  somewhat  lengthy  nature,  and  may 
not  near  its  conclusion  until  the  third  or  fourth  day. 

Diag^nosis. — In  some  cases  this  is  remarkably  simple  ; 
in  others  just  as  difficult.  After  all  is  said  and  done, 
there  can  be  but  one  absolutely  diagnostic  symptom,  and 
that  is  the  detecting,  by  manipulative  measures  in  the 
rectum,  of  the  offending  portion  of  bowel. 

It  will  be  seen,  however,  that  I  have  carefully  refrained 
from  giving  symptoms  which  might  be  truthfully  de- 
scribed as  general,  from  which  I  wish  the  reader  to  infer 
that  such  few  as  I  have  related  I  wish  to  be  regarded  as 
reasonably  diagnostic.  That  being  so,  I  will  conclude 
this  paragraph  by  simply  summing  them  up  again  in 
brief. 

The  continuousness  of  the  pain,  as  evidenced  by  the 
state  of  the  pulse,  without  definite  concomitant  symptoms 
pointing  to  a  more  grave  condition,  as,  for  example, 
enteritis,  twist,  or  rupture  ;  the  tendency  to  stand  in  a 
stretched-out  posture,  with  ejected  penis  and  quivering 
tail ;  the  gradual  increase  in  the  severity  of  the  pains  if 
not  soon  relieved ;  the  violent  straining  attempts  at  de- 
faecation,  and  the  clinging,  clutch-like  grasp  of  the  rectum 
on  the  operator's  arm  ;  the  violently  expulsive  action  of 
the  rectum  on  anything  introduced  per  animi,  and  the 
presence  in  the  pelvis  of  distended  or  flaccid  coils  of  in- 
testine— all  these  are  symptoms  requiring  careful  con- 
sideration when  summing  up  for  a  diagnosis. 

Without  rashly  venturing  the  opinion  that  these  miani- 
festations  may  be  relied  upon  to  furnish  a  correct  verdict 
in  every  case,  I  am,  nevertheless,  fully  decided  that  many 
of  these  attacks  will  thus  be  absolutely  differentiated 
from  other  forms  of  colic,  and  a  corresponding  improve- 
ment in  the  treatment  be  the  happy  result.  In  course  of 
time  this  should  lead  to  the  report  of  further  cases  by 


SUBACUTE  OBSTRUCTION  OF  THE  SINGLE  COLON     143 

other  veterinarians,  and  an  increase  of  information  on  this 
particular  subject  should  be  engendered  by  the  working 
upon  it  of  more  than  one  set  of  brains. 

Prog"nosis. — In  a  former  chapter  of  this  book  I  have 
definitely  stated  that  any  case  of  colic  is  to  be  regarded 
as  serious  if  distended  coils  of  intestine  are  to  be  found  in 
the  pelvis.  A  consideration  of  such  cases  of  obstruction 
of  the  single  colon  as  have  fallen  to  my  share  leads  me 
in  no  great  degree  to  deviate  from  that  earlier-formed 
conclusion.  I  therefore  feel  myself  justified  in  advising 
the  veterinarian  to  offer  his  client  a  cautious  and  guarded 
explanation  of  the  state  of  affairs.  Should  the  day 
fortunately  arise  when  operative  interference  with  the 
horse's  abdomen  becomes  a  more  frequent  occurrence, 
then  this  particular  form  of  colic  will  be  the  first  to 
benefit  thereby,  and  so  yield  a  prognosis  of  a  more 
favourable  type.  If  the  case  is  one  of  rectal  paralysis, 
pure  and  simple,  then  the  prognosis  must  be  even  more 
guarded  still.  These  cases  are  generally  insidious  in 
their  onset,  and  usually  unaffected  by  therapeutic 
measures. 

Treatment. — Taking  the  case  of  total  paralysis  of  the 
rectal  walls  first,  we  may  dispose  of  it  very  briefly  by 
saying  that  a  trial  should  be  given  to  a  long  course  of 
nervine  tonics — e.g.,  strychnia,  which  tonic  is  well  accom- 
panied by  potassium  iodide  as  a  resorbent.  The  applica- 
tion of  a  smart  blister  to  the  lumbar  region  should  be 
advised,  and  the  patient's  daily  comfort  should  be  insured 
by  removing  from  the  rectum  several  times  per  diem 
the  accumulated  faecal  matters. 

Concerning  the  impaction  of  the  colon,  I  would,  as  for  the 
other  forms  of  subacute  obstruction,  advocate  the 
adoption  of  purely  stimulative  measures ;  in  which  case 
the  balls  of  ammonium  carbonate  and  nux  vomica  may 


144  1^^^  COMMON  COLICS  OF  THE  HORSE 

be  administered  as  for  the  colic  treated  of  in  the  last  two 
chapters.  These  should  again  be  followed  up  by  the 
regular  administration  (every  two,  three,  or  four  hours) 
of  boli  of  zingib.  rad.  pulv.  and  ammonium  carbonate, 
together  with  the  exhibition  of  copious  oleaginous 
draughts  combined  with  ol.  tereb.  and  ether  meth.,  ol. 
menth.  pip.,  spt.  eth.  nit.,  or  any  other  diffusible  stimu- 
lant that  may  suggest  itself. 

Although  it  is  not  my  own  practice,  I  would  also 
mention  that  a  dose  of  aloes  is  not  seriously  contra- 
indicated.  In  fact,  in  this  instance,  there  is  only  one 
argument  that  can  fairly  be  advanced  against  it,  and 
that  is  the  fact  that  in  some  cases  aloes  does  not  act  at 
all,  but  passes  off  by  the  kidneys.  Should  that  happen, 
the  veterinarian  unfortunately  receives  no  intimation 
thereof,  and  is  thereby  restrained  (by  fear  of  causing 
superpurgation)  from  pushing  on  that  vigorous  stimula- 
tive treatment  which  his  own  common -sense  would 
immediately  suggest  were  he  only  positively  certain  of 
the  non-acting  of  the  drug  upon  which  he  has  placed 
reliance. 

After  the  expiration  of  ten  to  twelve  hours,  should  the 
case  show  no  improvement,  it  will  be  necessary  to 
seriously  consider  the  advisability  or  otherwise  of  ad- 
ministering a  hypodermic  dose  of  eserine,  regarding 
which  I  have  a  remark  to  make.  I  do  not  pretend  to 
offer  any  explanation  of  the  fact,  but  I  do  most  con- 
fidently assert  that  in  this  particular  form  of  obstruction 
eserine  does  not  show  itself  to  its  happiest  advantage. 
To  my  mind  that  points  out  a  satisfactory  solution  of 
what  was  to  me  at  one  time  a  serious  problem.  I  could 
not  understand  veterinarians  of  experience  rising  to  their 
feet  at  various  meetings  and  emphatically  declaring 
eserine  to  be  of  no  value  in  colic  cases  :  that  it  did  not 


SUBACUTE  OBSTRUCTION  OF  THE  SINGLE  COLON     I45 

act  as  it  was  said  to  do.  In  the  light  of  fuller  experience 
I  am  able  to  see  an  adequate  reason.  They  had  not  used 
eserine  on  suitable  cases.  In  spite  of  my  opinion  that 
this  is  not  its  happiest  forte,  however,  it  still  remains  a 
fact  that  eserine  does  act  occasionally,  even  in  posteriov 
obstruction  of  the  colon  ;  and,  after  other  remedies  have 
been  given  a  trial  of  from  ten  to  twelve  hours,  its  exhibition 
should  no  longer  be  delayed.  The  dose  should  not  be  a 
large  one.  Should  it  fail  to  act,  as  I  have  already  said 
it  may  do,  then  the  active  peristalsis  set  up  in  the 
intestines  anterior  to  the  seat  of  obstruction  is  extremely 
likely  to  lead  to  a  fatal  lesion  of  the  intestines  or  the 
mesenteric  bloodvessels.  There  is,  however,  no  risk  in 
the  administration  of  a  small  dose,  say  one  grain. 

In  view  of  what  I  have  said  concerning  the  likely 
nervous  causation  of  this  disorder,  no  one,  I  should 
imagine,  will  expect  me  to  advocate  the  use  of  sedatives. 
If  it  were  possible  to  do  so,  I  would  denounce  their 
administration  in  even  stronger  terms  than  I  have  already 
used.  I  find  it  impossible  to  do  so,  however,  and  must 
content  myself  with  the  simple  statement  that  their  use 
is  undoubtedly  most  strongly  contra-indicated. 

If  the  obstruction  is  within  comfortable  reach,  the 
veterinary  surgeon  should  carefully  knead  it  with  the 
knuckles  of  his  closed  fist  through  the  rectum,  endea- 
vouring to  crush  it  between  his  hand  and  the  floor  of  the 
pelvis.  It  may,  and  does,  cause  pain,  but  it  is  also 
productive  of  good  results. 

It  goes  without  saying  that,  in  addition  to  whatever 
treatment  is  being  adopted,  copious  enemas  should,  at 
the  same  time,  be  freely  indulged  in.  In  fact,  the  ap- 
paratus for  so  doing  should  be  left  with  the  attendants  if 
the  veterinary  surgeon  is  unable  himself  to  frequently 
attend.     The  water  should  be  used  as  hot  as  regard  for 

lo 


I46  THE  COMMON  COLICS  OF  THE  HORSE 

the  animal's  safety  will  allow,  and  with  it  should  be 
included,  at  intervals,  some  good  stimulating  agent. 
Whether  detached  pieces  of  faeces  come  away  with  the 
ejected  water  or  not,  the  rectal  irrigation  should  be  per- 
sisted in,  and  the  attendants  should  be  firmly  impressed 
with  the  idea  that  it  is  the  constant  warmth  that  tends  to 
do  good. 

Should  all  these  means  prove  futile  and  the  case  still 
linger  on,  the  long  rectum-tube  of  Smith  should  be 
passed  into  the  gut  and,  if  possible,  while  a  stream  of 
water  is  passing  through  it,  inserted  for  the  whole  of  its 
length.  It  is  important  to  keep  a  constant  flow  of  w^ater, 
at  a  fairly  high  pressure,  through  the  tube,  in  order  that 
it  may  find  a  ready  and  correct  road.  In  case  the  tube 
should  not  be  available,  a  similar  length  of  garden-hose 
of  suitable  stiffness  will  answer  tolerably  well.  The  only 
drawback  to  the  use  of  the  rectal  tube  is  the  need  of  a 
forced  water-supply.  To  those  resident  in  a  country 
district  that  obstacle  to  a  correct  treatment  is  in  most 
cases  an  insurmountable  one — unless  the  animal  is 
walked  to  the  nearest  market-town  to  the  veterinary 
surgeon's  establishment. 

Finally,  if  all  the  efforts  of  the  veterinary  attendant 
are  in  vain,  he  may,  if  his  position  will  bear  the  shock  of 
a  serious  failure,  and  the  age  of  the  animal  and  its  market 
value  warrant  him,  talk  to  his  client  of  operative  measures. 
But  of  that  more  in  a  future  chapter. 


CHAPTER  XII 

SUBACUTE   OBSTRUCTION  OF  THE 
SMALL    INTESTINES. 

Definition. — In  spite  of  the  fact  that  post-mortem 
records  have  not  yet  described  a  case  of  obstruction  of 
the  small  intestines,  I  feel  led,  by  the  clinical  evidence 
I  have  obtained,  to  give  it,  or  at  any  rate  the  possibility 
of  its  occurrence,  a  place  of  description.  Clinical  evi- 
dence, as  I  hope  this  chapter  will  show,  offers  for  our 
consideration  a  form  of  obstruction  whose  position  in  the 
intestinal  tract  is  certainly  far  forward  in  the  double 
colon.  Whether  further  forward  still,  and  obstructing 
the  small  intestines,  only  future  records  will  show.  What 
evidence  is  obtainable  appears  to  point  strongly  to  the 
fact  that  obstruction  of  the  duodenum  does  sometimes 
occur,  and  that  '  stoppage '  pains  are  not  always  to  be 
precipitously  referred  to  the  single  or  double  colon.  The 
only  argument  against  that  statement  is  the  one — '  post 
mortem  records  have  iiot  shown  it.'  Purely  negative  evi- 
dence, however,  is  seldom  really  satisfactory  ;  and  I  hope 
that  the  symptoms  hereafter  described  will  substantiate 
my  statement  that  obstruction  of  the  small  intestines, 
most  probably  of  the  duodenum,  has  sometimes  to  be 
reckoned  with. 

Causes. — Regarding  the  causes  of  colic,  I  am  afraid 

lO — 2 


148  THE  COMMON  COLICS  OF  THE  HORSE 

that  I  have  run  almost  to  the  end  of  my  tether — or,  rather, 
have  already  enumerated  them — and  must  again  refer  my 
readers  to  former  chapters,  allowing  them  to  use  their 
own  discretion  in  each  particular  case  as  to  which  special 
causative  factor  they  should  give  prominence  to.  Still, 
there  are  one  or  two  circumstances  that  merit  special 
mention. 

Foremost  should  come  consideration  of  the  duodenal 
S-trap.  It  is  not  hard  to  conceive  of  the  possibility  of 
this  being  a  likely  position  for  obstruction.  Pressed,  as 
it  sometimes  is,  between  the  stomach  and  a  distended 
colon,  it  would  be  remarkable  if  obstruction  did  not 
occur.  Neither  is  it  difficult  to  imagine  that  food  im- 
perfectly masticated  and  passed  on  in  a  half-digested  or 
acid  condition  from  the  stomach,  and  consequently  unfit 
to  be  acted  upon  by  the  bile,  should  tend  to  stagnate  in 
the  duodenum. 

Following  this,  those  morbid  conditions  of  the  liver 
that  are  instrumental  in  bringing  about  these  disorders 
should  be  given  attention.  I,  in  common  with  many 
others,  have  noticed  that  prolonged  feeding  on  rich 
nitrogenous  foods  will  bring  about  a  plethoric  condition 
of  the  body  that  makes  its  first  appreciable  appearance  in 
some  disturbance  of  the  liver  functions.  The  animal 
becomes  bilious.  Congestion  of  the  liver,  or  the 
diminished  flow  of  bile  from  any  cause,  may,  then,  be  put 
down  as  a  factor  in  the  production  of  duodenal  obstruc- 
tion, for,  with  a  lessened  flow  of  bile,  the  digestion  is 
imperfect,  and  a  tendency  to  stasis  is  occasioned. 

Symptoms. — Almost  invariably  the  pains  that  ac- 
company this  disorder  are  those  of  an  extremely  dull 
type — even  more  dull  than  those  that  have  already  been 
described  as  dull  pains.  Pain  of  a  degree  there  certainly 
is,  but  a  certain  amount  of  time  must  be  given  over  to  its 


SUBACUTE  OBSTRUCTION  OF  SMALL  INTESTINES     l<9 

consideration  before  it  can  be  accurately  traced  to  its 
correct  source. 

For  some  days  prior  to  the  exhibition  of  signs  of  un- 
easiness, the  animal  has  been  heavy,  has  not  performed 
his  work  with  activity  and  brightness,  has  appeared 
unusually  dull  and  drowsy.  When  down  he  lies  quiet 
for  a  considerable  time,  and  only  occasionally  manifests 
the  seat  of  trouble  by  a  quiet  look  round  at  the  flank. 
Rectal  exploration  reveals  the  presence  of  a  few  small, 
hard  faecal  lumps,  which  are  abnormally  dark  in  colour. 
The  colon  and  such  of  the  bowels  as  can  be  felt  are  not  ab- 
normally full,  neither  is  there  any  iindne  fulness  or  tympany  of 
the  abdomen.  The  pulse  is  raised  a  little  beyond  the 
normal,  and  is  firm  and  full  to  the  fingers.  The  tem- 
perature shows  slight  signs  of  febrile  disturbance,  and 
the  conjunctiva  is  plainly  stained  a  muddy  yclloiv,  more  so, 
even,  than  is  seen  in  that  form  of  colic  that  is  plainly 
referable  to  the  great  colon.  The  mouth  is  dry  and 
sticky,  and  the  odour  of  the  breath  abominably  offensive, 
while  the  tongue  and  buccal  mucous  membranes  are 
stained  in  like  manner  as  the  conjunctiva. 

It  is  not  common,  however,  for  the  veterinary  surgeon 
to  be  called  in  at  this  stage.  When  first  he  sees  the 
case,  the  symptoms  are  more  after  this  description  : 

The  pains  have  become  a  great  deal  more  noticeable, 
but  still  remain  under  the  category  of  '  dull.'  The 
getting  up  and  down  has  become  more  frequent,  although 
fairly  long  intervals  of  ease  are  even  now  common.  ,  The 
pain,  when  it  does  come  on,  is  most  intense  just  after  the 
expulsion  of  a  watery  and  extremely  offensive  purge,  but 
rapidly  subsides  immediately  after  the  first  few  minutes 
succeeding  the  evacuation.  While  the  surgeon  is  watch- 
ing his  case  this  purge  may  be  repeated  two  or  three 
times  within  the  hour. 


I50  THE  COMMON  COLICS  OF  THE  HORSE 

Called  in  at  this  stage,  the  young  practitioner,  unless 
extremely  wary,  will  be  tempted  to  treat  his  case  as  one 
of  simple  diarrhoea,  and  administer  astringents  and 
sedatives.  Needless  to  say,  he  commits  a  grave  error. 
If,  on  the  other  hand,  he  is  possessed  of  caution,  and 
first  explores  per  rectum,  he  will  find  a  state  of  affairs 
there  that  does  not  fairly  substantiate  his  first  surmises. 
Certainly  he  will  find  the  rectum,  and  probably  also  the 
single  colon,  with  their  contents,  in  a  fluid  condition.  In 
addition,  however,  he  will  discover  other  portions  of  the 
intestines  still  containing  fcBcal  matter  in  a  state  of  solidity — 
proof  positive  that  the  purging  has  not  been  in  existence 
for  long,  and  equally  positive  proof  that  the  purgation 
is  not  accountable  for  the  dull  pains  that  the  carefully 
ehcited  history  of  the  case  has  spoken  of.  Immediately 
on  noting  this,  he  will,  if  his  clinical  training  be  good, 
also  observe  that  the  pains  the  animal  is  showing  are  not 
of  the  kind  that  usually  accompany  the  colic  from  exces- 
sive purging  (see  Chapter  XVII.).  There  is  not  the 
tucked-up  condition  of  the  flank  ;  there  is  no  excessive 
peristalsis  on  auscultation  ;  there  is  no  great  alteration 
in  the  number  of  respirations  nor  their  character,  and  the 
pulse  is  not  in  that  weak  and  fluttering  condition  so 
commonly  coexistent  with  colic  from  superpurgation. 
Neither  will  the  animal  show  desire  for  the  water  offered 
him. 

This  affords  a  suitable  opportunity  for  mentioning  a 
symptom,  which,  until  now,  has  been  carefully  omitted. 
It  is  a  well-known  fact  that  the  horse  suffering  from 
obstructive  colic  cannot,  except  in  very  rare  cases,  be 
persuaded  to  drink.  In  this  particular  instance  it  is 
almost  proof  that  the  animal  is  suffering  from  the  pains 
of  obstruction,  and  not  those  occasioned  by  an  excessive  purge. 
If  it  were  the  latter,  he  would  be  eagerly  looking  round 


SUBACUTE  OBSTRUCTION  OF  SMALL  INTESTINES     151 

on  every  rattle  of  a  bucket,  and,  permitted,  would  drink 
to  an  alarming  excess. 

If  the  veterinarian  is  of  the  same  mind  as  myself, 
having  decided  that  the  purging  is  not  directly  account- 
able for  the  pains,  he  will  refrain  from  giving  the  animal 
sedatives.  .  .  .  He  will  treat  the  case  purely  as  obstruc- 
tion, and  persist  in  a  solely  stimulative  treatment. 
Should  he  do  so,  he  will,  on  his  next  visit  to  the  case, 
have  every  reason  to  be  delighted  with  his  judgment. 
If  it  is  his  first  case  of  this  description,  he  will  be  quite 
anxious  to  learn  whether  or  no  the  purging  has  stopped 
unaided.  He  is  pleased  to  find  that  such  is  the  case,  and 
to  hear  that  the  animal  has  passed  nothing  for  four,  five, 
or  six  hours. 

Even  now  there  may  be  an  element  of  doubt,  and  the 
concerned  thought  is  that  the  excreta  is  so  thin  as  to  be 
running  through  the  bedding  and  so  escaping  notice. 

The  dry  tail  does  not  point  to  it,  and  rectal  exploration 
again  settles  the  question.  The  interior  of  that  bowel  is 
quite  dry,  and  sometimes  contains  chippy  pieces  of  dried 
faeces.  And  still  the  animal  is  in  pain — dull  pain — still 
peristalsis  is  in  abeyance. 

The  veterinarian  knows  now  by  rectal  exploration 
and  the  evidence  of  his  senses  (to  wit,  the  sight  of  the 
purging)  that  the  last  portions  of  the  intestines — the 
single  and  double  colons — are  comparatively  empty. 
The  stoppage  or  obstruction  must  lie  further  forward. 
It  is  not  likely  to  be  in  the  floating  portion  of  the  small 
intestines  ;  that  he  knows  from  post-mortem  experience. 
It  must,  therefore,  be  situate  in  the  duodenum,  and  the 
excessive  biHary  staining  of  the  mucous  membranes  is 
now  somewhat  accounted  for.  Holding  back  from  ad- 
ministering sedatives  has  left  him  in  a  position  to  treat 
his  case  on  rational  and  not  empirical  lines. 


152  THE  COMMON  COLICS  OF  THE  HORSE 

Correctly  treated,  the  animal  may  begin  to  mend  in  a 
few  hours,  or  the  pains  may  last  for  as  long  as  seven  or 
eight  days.  Commonly  it  is  only  a  day  or  two  before  the 
animal  is,  to  all  appearances,  fully  recovered. 

In  every  case  I  have  yet  seen  the  critical  symptom  ap- 
pears to  be  the  voiding  of  a  huge  mass  of  faeces  (clay -like, 
both  in  colour  and  consistence)  from  the  anterior  end  of 
the  intestinal  tract.  The  offensive  smell  from  this  can  only 
be  fitly  described  as  '  disgusting.'  From  that  time  on- 
ward the  pains  of  obstruction  vanish,  and  after  a  few  days' 
careful  dieting  and  nursing,  the  animal  is  out  of  danger. 

Diagnosis. — Much  of  the  matter  under  this  heading  is 
often  but  a  reiteration  of  facts  related  under  the  symptoms. 
Little  thus  remains  for  the  writer  but  to  emphasize  in 
brief  such  symptoms  as  he  regards  as  diagnostic. 

Primarily,  we  must  consider  the  long  period  of  general 
dulness  noticed  by  the  attendants  before  skilled  advice 
is  sought ;  the  comparative  absence  of  fulness  of  the 
abdomen  as  revealed  by  rectal  exploration,  and  the  non- 
appearance of  tympany;  the  biliary  staining  of  the 
conjunctiva,  and  the  clammy,  fcetid  condition  of  the 
mouth,  with  the  yellowness  of  the  buccal  membranes. 
These  may  all  be  regarded  more  or  less  as  premonitory 
diagnostic  symptoms,  and  it  is  not  until  the  more  notice- 
able colic  pains  come  on  and  the  offensive  purge 
commences  that  the  veterinarian  is  able  to  fully  satisfy 
himself  as  to  the  correct  nature  of  his  case. 

The  character  of  the  purge  is  doubtless  due  to  want  of 
sufficient  bile  in  the  intestines.  The  bile  exerts  certain 
antiseptic  effects  on  the  intestinal  contents,  and  when  it 
is  withheld  extreme  foetor  of  the  faecal  matters  is  a  con- 
sequence. Thus,  the  foetor  may,  to  a  certain  extent, 
serve  somewhat  in  locating  the  seat  of  trouble — may,  in 
fact,  in  this  case,  be  relied  on  as  a  diagnostic. 


SUBACUTE  OBSTRUCTION  OF  SMALL  INTESTINES     I53 

When  the  purge  has  commenced,  and  the  veterinary 
surgeon  is  able  to  accurately  judge  that  this  purge  is  not 
the  actual  cause  of  the  colic,  it  is  time  he  looked  round 
for  some  other  explanation  of  the  pains.  When,  laten 
the  purge  ceases  in  a  natural  manner,  without  medicinal 
help,  and  the  pains  still  remain  in  continuance,  it  is  a 
fairly  reasonable  conclusion  that  obstruction,  in  some 
position  or  other,  is  still  to  be  looked  for. 

The  emptiness  of  the  abdomen  generally  and  the 
absence  of  tympany  compel  the  veterinarian  to  place  it 
far  forward,  and,  admitting  the  fact  that  it  is  unlikely  to 
be  in  the  floating  coils  of  small  intestines  in  the  left 
flank,  the  diagnosis,  so  far  as  we  are  yet  able  to  settle 
it,  is  complete.  We  have  summed  up  our  case,  and 
'duodenal  obstruction,'  with  congestion  of  the  liver  as 
a  primary  cause  or  after-complication,  is  the  verdict. 

Prog'nosis. — I  cannot  say  that  my  experience  of  these 
cases  leads  me  to  regard  them  at  all  unfavourably.  They 
may,  as  I  have  before  stated,  linger  on  for  several  days, 
but  never  during  that  time  do  they  offer  alarming 
symptoms.  One  visits  the  case  every  four  or  six  hours, 
or,  should  it  prove  protracted,  twice  daily,  and  each 
examination  reveals  the  animal  strong  and  the  pulse 
good.  The  only  untoward  symptom  of  any  gravity — 
one  which  I  have  never  yet  seen — would  be  a  steady 
continuance  and  increase  in  the  purgation.  This  being 
the  case,  the  owner  may,  with  every  safety,  be  assured 
of  a  favourable  issue. 

Treatment. — Broadly  speaking,  the  treatment  of  this 
disorder  must  be  conducted  in  two  ways  :  Firstly,  the 
obstruction  in  the  intestine  should  be  removed  ;  secondly, 
such  medicines  should  be  administered  as  will  bring  the 
liver  to  a  healthy  and  normal  condition,  and  so  prevent  a 
recurrence  of  the  attack. 


154  THE  COMMON  COLICS  OF  THE  HORSE 

Those  who  have  carefully  read  the  preceding  portions 
of  this  book  will  see  no  great  difficulty  in  carrying  out 
the  first  of  these  directions.  Again,  I  do  not  advise  the 
administration  of  aloes ;  at  any  rate,  not  as  a  dependable 
agent.  The  mere  fact  of  the  bile  being  thrown  back  in 
sufficient  quantities  into  the  blood-stream  to  stain  the 
visible  mucous  membranes  is  ample  evidence  that  it  will 
not  be  found  freely  enough  in  the  duodenum  to  assist  in 
the  solution  of  the  administered  aloes.  Assuming  that 
the  obstruction  has  set  up  such  inflammatory  changes  as 
to  cause  a  diphtheritic  closure  of  the  bile-duct,  and  that 
there  is  collected  bile  in  the  intestine,  should  calomel  be 
given  in  order  to  hasten  its  expulsion  ?  I  am  of  the 
opinion  that  no  great  amount  of  good  is  to  be  derived 
from  that,  unless  the  system  is  at  the  same  time  helped 
by  suitable  stimulant  treatment  in  order  to  first  remove 
the  obstruction. 

That  statement  brings  us  back  again  to  the  ammonium 
compounds  as  our  sheet-anchor — again  advantageously 
combined  with  nux  vomica  or  other  nerve  stimulants. 
Consequently,  for  the  treatment  I  may,  with  one  excep- 
tion, refer  the  reader  to  that  advised  for  obstruction  of 
the  double  colon.  The  exception  is  the  hypodermic 
injection  of  eserine.  I  do  not  believe,  in  this  particular 
form  of  colic,  its  administration  is  called  for.  At  any 
rate,  any  idea  of  using  it  may  be  safely  postponed  until 
the  case  has  been  treated  on  other  lines  for  some  few  days. 

Once  more,  I  earnestly  caution  the  practitioner  to 
avoid  sedatives.  Even  when  the  purging  breaks  out  he 
should  still  persist  in  a  solely  stimulative  treatment,  for 
it  is  not  until  the  obstructive  mass  in  the  duodenum  is 
removed  that  he  may  regard  his  case  as  out  of  danger. 

When,  after  the  period  of  purgation  (which  always 
seems  to  accompany  these  cases),  the  physician  has  once 


SUBACUTE  OBSTRUCTION  OF  SMALL  INTESTINES     i55 

obtained  a  normal  action  of  the  bowels,  he  may  continue 
with  calomel  in  small  dosfes  to  clear  the  intestine  of  the 
accumulated  bile.  He  should,  at  the  same  time,  put  the 
animal  upon  a  course  of  such  medicines  as  are  known  to 
favourably  influence  liver  functions,  and  so  increase  the 
bile  secretion. 

Probably  the  most  suitable  remedy  in  this  case  is  one 
of  the  mineral  acids.  Before  reaching  the  circulation, 
acids  imist  pass  tJirough  the  liver,  where  they  appear  to  set 
free  biliary  acids,  and  stimulate  expulsion  of  bile  from 
the  liver  and  gall-bladder.^  The  acid  to  be  preferred  is 
nitric  or  nitro-hydrochloric,  and  the  following  draught 
should  be  administered  twice  daily  for  three  or  four  days  : 

R.  Acidi  nitrici  dil.         -         .         •         -     5i' 
Aquam      -         -         -        -        -        -    ad  Oi. 

Misce ;  fiat  haust. 

Should  the  practitioner  decide  not  to  administer  the 
acid,  he  may,  now  that  the  obstruction  is  removed, 
employ  aloes  with  advantage.  Prescribed  in  i-drachm 
doses  once  daily  for  three  or  four  days,  combined  with 
ginger,  gentian,  or  other  vegetable  tonics,  it  will  exert  a 
mild  cathartic  action,  removing  the  bile  from  the  intes- 
tines and  stimulating  the  liver  into  activity. 

These  attacks  of  duodenal  obstruction,  when  the  liver 
is  to  any  great  extent  implicated,  appear  always  to  leave 
the  animal  in  a  state  of  great  weakness  and  prostration — 
perhaps  better  described  as  want  of  tone  and  general 
lassitude.  An  easily  digested  diet  is  therefore  called  for, 
and  the  animal  should  be  treated  as  convalescent  for 
some  considerable  time.  The  simpler  the  diet,  the 
better  —  bran  with  a  few  crushed  oats  and  a  liberal 
supply  of  good  hay  being  all-sufficient.  What  water  he 
'  'Veterinary  Medicines'  (Finlay  Dun),  p,  178. 


156  THE  COMMON  COLICS  OF  THE  HORSE 

has  should  be  medicated  with  2  or  3  ounce  doses 
of  magnesium  sulphate,  and  the  kidneys  may  be  induced 
to  carry  off  their  share  of  the  accumulated  effete 
materials  by  judicious  doses  of  potassium  nitrate,  either 
in  the  drinking  water  or  the  patient's  food. 

This  chapter  I  will  conclude  with  a  very  brief  account 
of  two  cases,  which  will  serve  to  illustrate  what  I  have 
already  written.  In  their  description  I  do  not  intend 
giving  a  daily  account  of  the  symptoms  ;  that  would 
take  up  much  of  my  space  to  but  little  advantage.  The 
reader  will  have  read  the  symptoms  of  this  disorder  for 
himself,  and  will  understand  that  my  relation  of  them 
has  been  based  upon  these  and  other  similar  cases. 
Consequently,  a  daily  record  of  the  symptoms  would  be 
but  the  most  fulsome  repetition. 

Case  No.  i, 

January  30,  1902,  3.30  p.m. — The  subject  of  this  case 
was  a  five-years-old  cart  mare  (barren).  I  attended  the 
owner's  farm,  some  five  miles  distant,  and  received  a 
history  of  general  dull  pains  spread  over  the  previous 
day.  The  pains  had  appeared  somewhat  worse  (never 
violent)  during  the  morning  of  this  day,  and  were  accom- 
panied several  times  by  a  nasty  purge.  This  had  led  the 
owner  to  send  for  me.  The  pains  the  mare  was  showing 
did  not  appear  to  be  proceeding  from  purgation;  they 
were  rather  the  ordinary  dull  pains  of  obstruction  that  I 
have  mentioned  so  often  throughout  this  book. 

To  make  assurance  doubly  sure  I  explored  the  rectum, 
and  found  that  bowel  containing  a  quantity  of  dirty  liquid 
fseces,  the  odour  of  which  was  offensive  in  the  extreme. 
Shortly  after  this  manipulation  the  mare  again  volun- 
tarily evacuated  a  large  quantity.  As,  however,  I  was 
unable  to  detect  the  usual  symptoms  of  superpurgation 
(see  Chapter  XVII.),  I  diagnosed  the  case  as  one  of  ob- 
struction, and  proceeded  to  treat  it  on  those  lines.  I  there- 
upon administered  the  balls  and  drench  as  advocated  in 


SUBACUTE  OBSTRUCTION  OF  SMALL  INTESTINES    157 

Chapter  IX.,  pp.  104  and  105,  and  left  draughts  con- 
taining diffusible  stimulants  for  after  administration, 
requesting  the  owner  to  let  me  know  on  the  following 
day  if  the  pains  had  not  ceased. 

January  31,  3.30  p.m. — My  attendance  was  again  re- 
quested, and  I  found  the  mare  exhibiting  much  the  same 
symptoms  as  on  the  previous  day,  with  the  exception 
that  the  purging  had  ceased  since  early  the  evening 
before.  Accordingly,  I  repeated  the  stimulant  treatment, 
and  left  further  medicines  of  a  similar  nature.  The  case 
was  showing  no  extreme  urgency,  and  I  did  not  propose 
seeing  it  again  until  the  following  day. 

February  i,  10.30  a.m. — The  pains  had  now  ceased, 
and  the  mare  inclined  to  pick  daintily  at  a  little  hay. 
The  critical  discharge  of  a  mass  of  clay-like,  offensive- 
smelling  faeces  had  taken  place.  I  still  continued  the 
frequent  administration  of  stimulants,  now  in  smaller 
doses  and  combined  with  vegetable  bitters  and  tonics, 
leaving  these  to  be  given  by  the  farm  attendants. 

February  2. — No  visit. 

February  3. — Mare  still  convalescent,  but  doing  well. 
Had  several  times  passed  normal-sized  heaps  of  faeces, 
healthy  in  colour  and  smell,  and  was  now  feeding  fairly 
well.  Advised  the  continuance  of  the  tonics  and  a  few 
days'  rest.     The  case  subsequently  did  well. 

Case  No.  2. 

This  case,  one  of  the  most  remarkable  in  my  experi- 
ence, was  treated  some  eighteen  miles  from  home.  It  is 
astonishing  to  me  as  showing  the  length  of  time  it  is 
possible  for  a  horse  to  suffer  from  the  pains  of  obstruc- 
tion and  then  recover.  I  need  hardly  say  that  it  is  one 
of  those  exceptions  that  go  to  prove  the  rule. 

February  21,  1900,  12  noon. — The  subject  was  a  six- 
years-old  cart  gelding.      The  owner,  a  client  of  mine, 

came  and  informed  me  that  he  had  a  horse  ill  at  M . 

I  had  never  attended  there  before  on  account  of  the 
distance,  but  was  persuaded  in  this  instance,  as  the  owner 
urged  that  the  animal  was  a  valuable  one,  that  he  was 
not  satisfied  with  the  treatment  the  horse  was  receiv- 


158  THE  COMMON  COLICS  OF  THE  HORSE 

ing,  and  that  he  was  unable  to  procure  skilled  advice 
nearer. 

On  my  arrival  I  found  that  the  animal  was  being 
attended  by  one  of  the  quacks  of  the  old  school,  and 
gathered  that  he  had  been  suffering  from  the  ordinary 
pains  of  colic  for  some  three  or  four  days  prior  to  my 
being  called  in.  I  could  not  gain  much  information  from 
the  empiric  himself,  but  learned  that  he  had  been  ad- 
ministering sedatives  and  aloes. 

I  immediately  insisted  on  having  sole  charge  of  the 
case,  and  commenced  a  vigorous  stimulative  treatment. 
I  knew  that,  in  addition  to  the  obstruction,  I  had  to  fight 
against  previously  administered  sedatives,  and  determined 
to  run  the  risk  of  creating  superpurgation  by  actively 
inciting  the  aloes  to  action.  Accordingly,  I  administered 
in  the  form  of  balls  the  usual  quantities  of  ammonium 
carbonate  and  nux  vomica,  in  i  and  2  ounce  doses 
respectively,  and  the  oil  of  turpentine  and  aromatic 
spirits  of  ammonia  in  i -ounce  doses,  with  linseed-oil  as  a 
draught.  That  done,  I  left  the  man  in  charge  of  the 
nursing  with  sufficient  balls  of  ammonium  carbonate 
and  vegetable  tonics  to  carry  him  on  until  the  following 
day. 

February  22,  9.30  a.m. — The  administered  stimulants 
had  had  the  effect  of  restarting  the  peristalsis  that  had 
been  stayed  by  the  sedatives,  and  the  animal  was  now 
purging.  Following  a  similar  line  of  reasoning  as  is 
described  under  the  section  devoted  to  diagnosis,  I  was 
able  to  ascertain  that,  in  spite  of  the  purging,  obstruc- 
tion was  still  present,  and  persisted  in  the  exhibition  of 
ammonium  carbonate  and  stomachic  tonics,  together 
with  draughts  of  ol.  lini,  ol.  tereb.,  and  spt.  eth.  meth. 

February  22,  6.15  a.m. — Save  that  the  purging  had  now 
stopped,  the  animal  was  in  much  the  same  condition  as 
in  the  morning,  and,  after  administering  the  usual  balls 
and  draughts,  I  injected  2  grains  of  eserine  sulphate 
under  the  skin  of  the  neck.  Beyond  putting  the  animal 
in  a  little  more  pain,  its  action  was  unnoticeable. 

February  23,. 9.30  a.m. — Seeing  that  there  was  still  no 
action  of  the  bowels,  I  again  administered  the  usual 
draught  and  six  of  the  ammonium  carbonate  balls,  after 


SUBACUTE  OBSTRUCTION  OF  SMALL  INTESTINES     159 

which  I  ventured  on  a  further  hypodermic  dose  of  eserine 
sulphate.  It  was  again  unproductive  of  good,  and  I  now 
decided  to  use  it  no  more  upon  this  particular  animal, 
but  to  maintain  a  regular  administration  of  such  stimu- 
lants as  could  readily  be  given  per  ovem. 

Fehvuavy  23,  6.15  p.m. — There  was  still  no  alteration  in 
the  symptoms,  save  that  the  animal  had  been  induced  to 
drink  a  little  thin  linseed  tea.  With  no  alteration  of  im- 
portance the  stimulative  treatment  was  continued. 

Febniayy  24,  9.30  a.m. — The  case,  to  all  appearances, 
was  in  the  same  condition  as  when  left  the  evening 
previous.  The  same  treatment  was  continued.  Tiring 
somewhat  of  the  case,  being  so  far  from  home,  and  the 
train  service  wretchedly  bad,  I  decided  to  see  it  no  more 
that  day,  but  left  the  man  in  charge  a  full  supply  of 
medicine,  with  instructions  to  desist  in  their  administra- 
tion rhould  the  animal  turn  easier  and  attempt  to  eat. 

Fehvuavy  25  {Sunday). — No  service  of  trains.  Decided 
to  leave  the  case  unseen  until  the  Monday  morning. 

Fehvuavy  26,  9.30  ajn. — Animal  weak,  but  recovered 
and  free  from  pain.  Feeding  delicately.  Appears  to 
have  suffered  eight  months  rather  than  eight  days.  On 
the  Sunday  he  had  passed  the  usual  mass  of  offensive 
dung,  which  had  been  saved  for  my  inspection.  Save 
the  careful  nursing  and  dieting  the  animal  caused  no 
further  anxiety,  and  made  an  uninterrupted  recovery. 

I  have  described  this  case  with  extreme  briefness. 
Lest  he  should  miss  the  point,  I  wish  the  reader  to 
clearly  understand  that,  at  intervals  of  about  every  six 
hours,  the  horse  received  2-ounce  doses  of  ammonium 
carbonate  for  the  w^hole  of  the  four  days  I  attended  him, 
to  say  nothing  of  the  frequent  administration  of  draughts 
containing  ol.  tereb.,  spt.  ammon.  aromat.,  or  spt.  eth. 
meth.,  as  my  judgment  led  me.  What  the  termination 
of  the  case  w^ould  have  been  had  the  old  empiric's  sedative 
treatment  been  continued  I  leave  my  reader  to  judge  for 
himself. 


This  concludes  my  somewhat  lengthy  description   of 
the  intestinal  obstructions.     Imperfect  as  I  yet  feel  it  to 


i6o  THE  COMMON  COLICS  OF  THE  HORSE 

be,  I  hope  I  have  now  written  enough  to  lead  other 
observers  to  the  more  exact  differentiation  and  diagnosis 
of  these  troublesome  disorders.  I  also  hope  that  the 
foregoing  descriptions  will  have  justified  me  in  daring  to 
thus  arbitrarily  subdivide  and  suggest  new  names  for  the 
time-honoured  (yet,  I  venture  to  affirm,  out-of-date)  title 
'  Impaction  of  the  Bowels.' 


CHAPTER  XIII 

INTESTINAL   IRRIGATION    IN    OBSTRUC- 
TIONS OF  THE  COLON 

The  subject  of  per  aniini  irrigation  of  the  intestines  is 
of  such  great  importance  as  to  merit  further  description 
than  the  bare  mention  in  Chapters  X.  and  XL  Par- 
ticularly in  the  subacute  varieties  of  colic  I  have  been 
describing  will  it  be  found  of  value.  Needless  to  say,  it 
is  obstructions  of  the  colon  that  will  be  best  benefited  by 
its  use.  I  am  not  referring  simply  to  the  passing  into 
the  rectum  of  a  few  pints  of  water  with  the  ordinary 
enema  syringe,  but  the  injecting  of  several  gallons  by 
means  of  a  forced  water-supply,  and  a  tube  that  may  be 
inserted  for  at  least  4  to  6  feet.  It  is  again  to  General  F. 
Smith  that  we  are  indebted  for  this  further  addition  to 
our  knowledge. 

Once  or  twice  in  this  volume  I  have  referred  to  im- 
pacted coils  of  intestine  being  found  in  the  pelvis. 
Whether  the  obstruction  be  in  the  small  colon  or  the 
large,  I  have  no  hesitation  whatever  in  saying  that 
forcible  irrigation  of  the  intestines  with  large  quantities 
of  water  will  do  more  than  anything  else  to  save  the 
patient's  life. 

If  the  obstruction  is  in  the  small  or  single  colon  the 
impacted  mass  is  comparatively  small   in  size,  usually 

II 


1 62  THE  COMMON  COLICS  OF  THE  HORSE 

about  the  diameter  of  a  large  cocoanut  (see  Fig.  ii). 
Should  the  obstruction  be  in  the  large  colon,  its  relatively 
larger  size  at  once  denotes  that  fact.  When  felt  through 
the  rectum,  it  gives  to  the  hand  the  impression  of  a  huge 
foetus  forced  close  to  the  pelvic  outlet.  Unless  soon 
reheved,  cases  of  this  description  quickly  put  the  im- 
plicated portion  of  bowel  into  a  state  of  obstinate 
paralysis. 

That  being  so,  if  the  usual  stimulative  treatment  fails 
to  give  early  good  results,  intestinal  irrigation  should  be 
at  once  commenced.  Only  one  or  two  trials  will  con- 
vince the  operator  of  the  great  value  of  the  treatment. 

The  only  apparatus  really  necessary  is  several  yards 
of  ordinary  rubber  garden-hose  of  about  J  to  f  inch 
in  diameter,  fixed  to  a  forced  water-supply.  My  own 
method  of  procedure,  however,  I  will  leave  for  the  time. 
So  far  as  I  am  able  to  trace,  General  Smith  was 
the  originator  of  this  treatment,  and  that  behoves 
me  to  give  his  case  prior  place.  It  is  reported 
in  the  Proceedings  of  the  Fifth  General  Meeting 
of  the  National  Veterinary  Association,  and  runs  as 
follows  : 

*  F.  54,  1 2th  Royal  Lancers,  a  grey  gelding,  five  years 
old,  was  admitted  at  4  p.m.  on  April  26,  suffering  acute 
abdominal  pain.  He  threw  himself  down  wath  great 
force  twice  before  means  could  be  taken  to  prevent  it, 
and  to  avoid  a  rupture  of  the  stomach  or  intestines  I 
placed  him  in  slings,  or,  rather,  attempted  to,  for  he  no 
sooner  felt  the  sling  under  him  than  he  lay  like  a  log  in 
it.  He  was  lowered  carefully  to  the  ground,  and  quickly 
hobbled,  and  a  great  source  of  anxiety  was  at  once 
removed.  Before  I  saw  him  he  had  passed  a  quantity 
of  loose  faeces,  and  the  usual  medicine  had  been  ad- 
ministered, but  he  was  getting  worse.  The  pulse  was 
quick  and  small,  respiration  greatly  increased,  con- 
junctiva   injected.      Examination    per    rectum    revealed 


INTESTINAL  IRRIGATION  163 

nothing.  I  at  once  gave  morphia  grs.  viii.  subcu- 
taneously,  and  administered  aloes  3v.  in  solution  ; 
applied  mustard  to  the  belly,  and  ordered  copious 
enemata  every-  hour  at  least.  He  was  quiet  for  fully 
half  an  hour  after  the  morphia,  and  at  9.30  p.m.  I 
considered  I  might  let  him  rise  with  safety.  He  was 
still  in  pain,  but  not  so  acutely,  was  kept  on  his  legs, 
hot  rugs  applied  to  the  abdomen,  and  mustard  to  the 
legs,  as  they  were  cold.  His  pulse  was  60,  soft  and  com- 
pressible ;  respiration  34  ;  temperature  102-6°  ;  conjunc- 
tiva injected.     He  remained  in  pain  all  night. 

*  April  27. — Delirious,  head  continually  going  to  and 
fro,  eyes  more  injected  ;  pulse  60,  very  weak  ;  respira- 
tion 40;  temperature  103°;  still  in  pain,  has  passed 
urine,  a  little  flatus,  but  no  action  of  the  bowels ;  on 
rectal  examination  these  are  found  distended  with  gas ; 
continue  the  enemata,  repeat  the  morphia,  and  constant 
application  of  hot  rugs.  Towards  mid-day,  the  morphia 
not  having  the  least  effect,  I  administered  ext.  cannabis 
indicse  §i.,  and  this  kept  him  quiet  for  a  few  hours. 

*  Evening. — Looks  very  wild,  eyes  glaring,  continually 
throwing  his  head  up  and  down  and  from  side  to  side, 
wants  to  walk  round  the  box  ;  pulse  48,  temperature  103°; 
12  p.m.,  still  in  pain,  repeat  the  Indian  hemp,  and  give 
ol.  lini.  Oi. ;  hot  rugs  to  abdomen  all  night,  and  the  usual 
enemata. 

'  April  28,  4  a.m. — In  great  pain,  nothing  passed  ;  in- 
jected morphia  grs.  viii.  6  a.m. :  The  last  dose  of  morphia 
had  no  effect,  temperature  105*6°,  pulse  almost  impercep- 
tible, conjunctiva  scarlet  and  spotted,  respiration  20, 
very  delirious  and  suffering  great  pain.  10  a.m.  :  Gave 
morphia  grs.  xvi.,  it  had  not  the  least  effect,  wandering 
continuously,  head  to  and  fro,  passed  a  few  small  pieces 
of  faeces,  and  strains.  The  case  is  most  serious,  and  the 
horse  will  certainly  die  of  pain,  if  he  does  not  from  the 
impacted  colon.  He  got  worse  during  the  day,  and  at 
5  p.m.  I  gave  him  ext.  cannabis  indicae  5ii.,  ol.  lini.  Oii. 
The  hemp  had,  as  usual,  an  immediate  and  lasting  effect ; 
he  stood  quietly  with  his  head  between  his  fore-legs  for 
two  or  three  hours.  The  enemata  administered  with 
the  ordinary   pipe  I  considered  so  utterly  useless,    and 

II — 2 


i64  THE  COMMON  COLICS  OF  THE  HORSE 

feeling  certain  that  the  impaction  was  in  the  colon  and 
only  required  to  be  reached,  I  passed  my  long  rectum 
tube  (kindly  made  for  me  by  Messrs.  Arnold  and  Son). 
I  first  passed  it  up  about  4  feet,  and  threw  in  about 
27  gallons  of  cold  water — 3  or  4  gallons  of  this  remained 
in  ;  what  was  rejected  brought  away  a  few  small  pieces 
of  faeces.  11  p.m.  :  There  is  great  dulness  over  the 
double  colon  at  the  epigastrium,  and  also  in  the  left 
hypochondrium  ;  I  believe  it  is  in  these  portions  where 
the  obstruction  exists  ;  I  again  passed  the  long  tube,  this 
time  6  feet,  and  threw  up  several  more  gallons  of  cold 
water — a  large  amount  of  this  was  retained.  He  was 
kept  thoroughly  under  the  influence  of  the  hemp,  pawed 
occasionally,  still  off  his  head,  but  much  quieter. 

'  April  29,  5  a.m. — Passed  the  long  rectum  tube  to  its 
full  extent — 6  feet — into  the  bowels,  and  threw  in 
13  gallons  of  cold  water,  which  were  retained  for  a  long 
time.  The  horse  is  quieter,  temperature  102°,  pulse 
stronger,  but  very  quick,  about  60;  the  conjunctiva  is 
clearer ;  the  dull  sound  of  the  epigastrium  and  left 
hypochondrium  is  considerable,  but  a  welcome  loud 
gurgling  is  heard.  11.30  a.m. :  Repeated  the  enema  with 
the  long  tube ;  slobbering  from  the  moath,  and  so  weak 
that  he  has  to  stand  with  all  his  legs  apart ;  the  pain 
suffered  is  insignificant.  5  p.m. :  Repeated  the  enema ; 
temperature  100°,  pulse  stronger,  conjunctiva  clearer  ;  am 
very  pleased  with  his  appearance,  and  confidently  expect 
his  bowels  to  act  shortly  ;  give,  however,  ol.  ricini.  Oii. 
Stood  quiet  all  night.     The  delirium  entirely  disappeared. 

April  30,  4  a.m. — Repeated  the  enema ;  straining 
greatly,  but  passed  nothing.  6  a.m. :  Passage  at  last 
effected  ;  passed  a  large  quantity  of  faeces,  mixed  with 
sand,  gravel,  and  stones  ;  temperature  100°.  During  the 
day  took  a  bran  mash  ;  passed  more  faeces,  with  gravel  and 
sand,  mid-day  and  evening.  Evening :  Pulse  fuller,  eye 
brighter,  removed  to  another  box  and  walked  very  tottery. 

*  The  record  of  this  case  need  not  be  continued,  for 
from  this  time  he  did  well ;  he  passed  the  gravel  for  a  few 
days,  and  it  then  ceased ;  he  lost  so  much  flesh  through 


INTESTINAL  IRRIGATION  165 

his  few  days  of  intense  suffering  that  it  took  two  months' 
nursing  to  replace. 

'  The  interest  in  this  case  is  centred  in  the  long  rectum 
tube.  From  a  considerable  experience  in  bowel  com- 
plaints, I  came  to  the  conclusion  some  time  ago  that  if  I 
could  throw  an  enema  into  the  colon  I  would  accomplish 
two  objects:  (i)  Would  act  directly  on  an  obstruction 
seated  far  forward,  and  (2)  would  place  the  enema 
beyond  the  expelling  powers  of  the  patient,  and  so  enable 
the  water  to  act  mechanically  on  the  contents  of  the 
bowel,  and  also  restore  the  tone  of  the  gut.  I  accord- 
ingly sent  to  Messrs.  Arnold  a  description  of  the  tube  I 
required  ;  it  was  to  be  6  feet  in  length,  made  of  gum 
elastic,  the  same  calibre  as  the  ordinary  Read's  enema 
tubing,  and  was  to  fasten  on  to  this  tubing  when  the 
ordinary  wooden  nozzle  was  unscrewed  ;  its  extremity 
was  to  be  round  and  perforated.  Messrs.  Arnold  sent 
me  the  exact  article,  which  I  have  no  hesitation  in  say- 
ing saved  the  life  of  the  horse  whose  case  I  have  just 
detailed.  There  is  no  difficulty  in  passing  it ;  having 
been  well  oiled,  with  gentle  pressure  it  finds  its  way 
along  the  course  of  the  rectum,  and  when  it  refuses 
to  go  further  no  force  should  be  used ;  all  that  is 
required,  should  it  be  necessary  to  pass  it  further  for- 
ward, is  to  pump  in  a  gallon  or  so  of  water,  which 
dilates  the  bowel  in  front  of  it,  and  the  passage  is  accom- 
plished. It  is  fair  to  state  that  I  have  had  cases  where  I 
could  not  get  more  than  half  that  distance  up,  probably 
owing  to  an  irritable  condition  of  the  gut,  but  even 
in  these  there  is  an  immense  advantage  gained  over  the 
ordinary  wooden  nozzle,  which  is  only  put  in  for  a  few 
inches.  I  have  constantly  made  experiments  with  the 
ordinary  apparatus  on  the  dead  subject  in  an  erect 
attitude,  and  find  that  with   it  no   enema  can  go  moie 


1 66  THE  COMMON  COLICS  OF  THE  HORSE 

than  4  or  5  feet  into  the  rectum,  so  that  for  obstruction 
in  the  colon  it  is  useless.  My  long  tube  throws  an 
enema  with  ease  into  the  single  colon,  and  probably  into 
the  double  one.  If  while  the  enema  is  being  given  the 
ear  be  applied  to  the  left  flank,  the  water  may  be  heard 
rushing  along  the  intestine.  The  tube  only  requires  to 
be  used  in  a  case  of  obstinate  obstruction  from  gravel, 
faeces,  etc.,  to  prove  its  great  value.  Before  I  was 
supplied  with  the  instrument  I  now  possess,  I  used  as  a 
substitute  the  tubing  that  is  found  on  Read's  enema 
syringe,  removing,  of  course,  the  wooden  nozzle.' 

Thus  runs  Colonel  Smith's  report  of  his  case.  Tavo 
facts  in  it  I  wish  to  point  out  to  the  reader :  First,  the 
apparent  uselessness  of  large  doses  of  sedatives  to 
thoroughly  allay  pain  in  a  serious  case  of  obstruction, 
and  the  evident  increase  in  alarming  symptoms  they  give 
rise  to.  Secondly,  the  almost  immediate  effect  of  the 
cold  water  irrigation  in  reducing  the  temperature. 

I  w^as  led  myself  to  adopt  this  treatment  as  a  result  of 
the  experience  of  a  fatal  case  of  obstruction  of  the  single 
colon  that  occurred  in  my  own  practice.  In  brief,  the 
case  was  this : 

Jtme  lo,  6  p.m. — I  was  called  to  attend  a  six-years-old 
gray  cart  mare  suffering  from  colic.  I  found  her  showing 
all  the  usual  symptoms  of  impacted  colon,  and  was  con- 
firmed in  my  opinion  by  finding  a  distinct  impaction  in 
the  pelvis.  As  is  my  usual  practice,  I  gave  four  balls 
containing  ammonium  carbonate  and  nux  vomica,  and 
administered  a  draught  of  ol.  lini.  Oi.,  ol.  tereb.  and  spt. 
amnion,  ar.,  of  each  gii.  Beyond  the  fact  of  finding  the 
impacted  coil  of  intestine  in  the  pelvis,  I  was  unable  to 
detect  any  alarming  symptoms.  The  pulse  was  good 
and  the  pains  not  excessively  violent.  After  watching 
her  for  some  time,  I  injected  hypodermically  i  grain  of 
eserine  sulphate,  and  left  her  for  a  few  hours. 

lo.^o  p.m. — The    symptoms    showed    no    abatement 


INTESTINAL  IRRIGATION  167 

The  eserine  had  failed  to  act.  The  puls^  was  sHghtly 
quicker,  and  the  impacted  intestine  in  the  pelvis  still 
present.  I  again  repeated  the  ammonium  carbonate 
balls,  minus  the  nux  vomica,  and  administered  a  further 
pint  of  oil.  At  the  same  time  I  injected  copious  warm 
enemas,  medicated  with  soap  liniment. 

June  II,  y  a.m. — I  was  disappointed  to  find  that  the 
case  showed  no  improvement.  The  pulse  had  risen  to 
80,  and  the  mucous  membranes  were  becoming  injected. 
No  ease  had  been  shown  since  my  last  visit.  The  case 
was  undoubtedly  becoming  worse.  I  again  repeated  the 
balls  and  stimulating  enemas,  and  injected  a  further  dose 
of  eserine. 

12  noon. — The  eserine  had  again  failed  to  act,  and  all 
the  symptoms  were  becoming  gradually  aggravated. 
There  were  constant  straining  efforts  to  defaecate,  and 
enemas  were  quickly  expelled,  as  clear  as  when  injected. 
In  my  own  mind  I  recognised  a  dying  case,  though  I 
still  persisted  in  giving  stimulants  and  oil. 

10.30  p.m. — Animal  gradually  succumbing.  I  had 
now  reached  the  end  of  my  tether,  and,  more  as  a  forlorn 
hope  than  in  any  other  spirit,  I  injected  a  further  and 
larger  dose  of  eserine — this  time  2  grains.  I  gave 
the  owner  a  fatal  prognosis,  and  promised  to  call  again 
in  the  morning. 

June  12,  7  a.7n. — The  case  had  slowly  gone  from  bad  to 
worse,  and  the  mare  was  now  evidently  dying.  No 
further  treatment  was  attempted,  and  the  animal  expired 
some  time  shortly  after  noon.  I  made  arrangements 
with  the  owner  for  a  post-mortem  to  be  held  the 
same  day. 

Autopsy.  —  The  knowledge  gained  from  this  was 
simple  enough,  though  painful  in  the  extreme.  Every 
portion  of  the  intestinal  tract  appeared  healthy.  In  no 
part  could  be  found  faeces  of  more  than  a  semi-solid 
consistence  —  save,  of  course,  the  impacted  portion — 
neither  were  the  bowel  contents  abnormally  excessive. 
The  impacted  intestine  was  quickly  withdrawn  from  the 
pelvis,  and  turned  out  to  be  a  portion  of  the  single  colon, 


i68  THE  COMMON  COLICS  OF  THE  HORSE 

distant  some  7  or  8  feet  from  the  anus.  The  obstruction 
was  nearly  round,  approaching  the  oval,  about  the  size 
of  a  cocoanut,  and,  seeing  that  it  was  composed  entirely 
of  dung,  extremely  hard.  It  presented  the  appearance 
depicted  in  the  accompanying  photograph : 


Fig.  II, — Impacted  Portion  of  Small  Colon  suspended  by 

Mesentery. 

A,  mesentery  ;  B,  the  obstruction  ;  C,  sacculated  folds  of 

intestine  ;  D,  longitudinal  band  of  intestine. 

No  other  suspicious  circumstance  was  present.  The 
case  was  clear  enough  both  to  myself  and  the  bystanders. 
Except  for  a  few  bright  red  patches  quite  near  to  the 
obstruction,  the  coats  of  the  intestine  were  clear  and 
clean. 

Remarks. — I  need  hardly  explain  to  the  reader  how 


INTESTINAL  IRRIGATION  169 

annoyed  I  was  that  the  impaction  was  so  small.  In 
every  probability,  had  the-  mare  been  operated  on  during 
the  first  day's  illness  and  the  obstruction  removed,  she 
would  have  lived.  Still  more  probable  would  her 
recovery  have  been  if  constant  intestinal  irrigation  had 
been  persisted  in.  The  fatal  obstruction  was  actually 
within  reach  of  a  tube  that  could  have  been  passed  a 
few  feet. 

Had  I  given  aloes,  would  the  issue  have  been  different  ? 
I  cannot  whip  myself  with  the  thought  that  it  would. 
Against  the  argument  that  aloes  would  have  moved  the 
obstruction  is  the  fact  that  the  contents  of  the  whole  of 
the  intestines  in  front  of  the  stoppage  were  in  a  semi- 
fluid state.  We  had,  in  fact,  by  using  the  oil  and  the 
nux  vomica,  created  a  purge  actually  washing  the  surface 
of  the  obstructing  lump.  My  only  regret  is  that  I  did 
not  then  know  the  value  of  the  long  rectal  tube  and 
a  bountiful  supply  of  water. 

The  next  case,  the  first  in  which  I  adopted  intestinal 
irrigation,  was  followed  by  recovery  : 

History. — The  patient  was  an  aged  black  cart  gelding, 
used  for  heavy  hauling  purposes — coal  carting.  He  had 
been  at  his  usual  work  all  the  week  until  late  on  the 
Saturday  afternoon.  He  ate  his  usual  feeds  on  Sunday 
morning  and  at  noon,  and  was  found  in  pain  about 
6  p.m.,  when  the  men  went  to  give  the  evening  meal. 

Sunday,  6.^0  p.m. — I  found  him  exhibiting  the  following 
symptoms  :  Pain  slight,  but  constant,  and  manifested  by 
a  ceaseless  pawing  with  one  fore-limb.  Pulse  about  68, 
but  inclined  to  be  fluttering  and  weak.  He  had  pre- 
viously been  rolling,  but  now  showed  no  inclination  to 
do  so.  Circumstances  did  not  permit  of  a  rectal  examina- 
tion. So  far  as  could  be  gathered  from  the  appearance 
of  the  abdomen,  there  was  no  trouble  in  the  large 
intestine.  That  was  surmised  from  the  complete  absence 
of  tympanites.     Diagnosis  was  withheld  until  a   rectal 


lyo  THE  COMMON  COLICS  OF  THE  HORSE 

examination  had  been  made.  I  administered  the  usual 
balls  of  stimulants,  but  was  quite  unable  to  get  a  draught 
down  him.  Left  word  with  the  owner  to  send  him  up  to 
my  own  stables  if  he  did  not  get  easier  before  9  p.m. 

g  p.m. — He  was  admitted  into  the  infirmary  and  the 
rectum  explored.  My  former  surmise  was  wrong,  for 
a  huge  mass  of  intensely  impacted  intestine — evidently 
the  large  colon — was  found  forcing  itself  right  into  the 
pelvis  within  6  inches  of  the  anus.  I  again  repeated 
the  balls,  and  failing,  owing  to  his  awkwardness,  to 
administer  a  drench,  gave  a  warm  enema,  containing  a 
large  quantity  of  turpentine  liniment,  in  the  hope  that 
some  of  the  turpentine  would  become  absorbed,  and  so 
excite  the  bowel  to  action.  The  pulse  still  maintained 
the  same  number  of  beats,  but  had  improved  somewhat 
in  tone.  As  the  animal  was  now  lying  down,  and  appeared 
fairly  comfortable,  I  decided  to  let  him  remain  until  the 
morning  before  attempting  further  measures. 

Monday,  7  a.m. — Patient  still  in  the  same  condition. 
Administered  hypodermically  i^  grains  of  eserine  sul- 
phate. This  put  him  in  slightly  more  pain  for  about  an 
hour,  after  which  he  again  grew  easier.  During  the 
hour  he  passed  a  few  small  quantities  of  faeces.  This 
I  judged  was  only  from  the  single  colon,  for  rectal 
exploration  still  revealed  the  presence  of  the  impacted 
coil  of  larger  intestine. 

12  Noon. — Still  failing  to  induce  him  to  take  my  usual 
doses  of  linseed  oil,  I  had  no  other  alternative  but  to  fall 
back  on  aloes.  I  administered  3  drachms  only.  The 
torpid  condition  of  the  bowels,  however,  promised  little 
hope  of  its  acting ;  that  being  so,  I  decided  to  irrigate 
the  colon  with  cold  water. 

4  p.m. — Connected  the  hose  with  the  ordinary  town 
water-supply,  and  forced  into  the  intestines  per  rectum 
several  gallons  of  cold  water.  I  found  it  impossible  to 
estimate  the  exact  quantity,  for  during  the  first  few 
minutes  of  passing  the  tube  there  was  a  fairly  constant 
flow  of  water  outwards  from  the  rectum ;  then,  as  the 
bowel  in  front  of  the  injecting- tube  expanded  owing  to 
the  pressure  of  the  water,  and  the  tube  found  its  way 
further  in,   the  flow  from   the  rectum   partially  ceased, 


INTESTINAL  IRRIGATION  171 

until  the  quantity  being  injected  must  have  far  exceeded 
that  dribbling  out.  At  this  period  of  the  injecting,  the 
ear  applied  to  the  left  flank  could  plainly  hear  the  water 
running  in.  What  was  more  pleasing  still  to  hear  was 
a  loud  rumbling  and  disturbance  of  the  intestines. 

After  keeping  the  stream  going  for  about  ten  minutes, 
during  which  time  several  gallons  must  have  found  a 
way  into  the  colon,  the  tube  was  withdrawn.  Beyond 
a  slight  shivering  of  the  haunches,  no  ill  effects  were 
noticed.  Indeed,  the  reverse  was  the  case,  for  the  pulse 
dropped  to  near  the  normal  in  number,  and  gained 
decidedly  in  tone.  The  animal  appeared  more  cheerful, 
and  even  partook  of  a  small  feed.  After  doing  so,  he 
again  showed  dull  pains,  but  the  general  condition  was 
distinctly  improving. 

The  quantity  of  water  injected  could  now  better  be 
estimated  by  the  frequent  evacuations  made  by  the 
animal.  From  the  time  of  the  injection  at  four  o'clock 
until  as  late  as  six  or  seven  he  passed  out  at  frequent 
intervals  a  stream  of  water.  At  first  this  came  away 
quite  clear ;  later  it  was  stained  a  muddy  yellow  ;  later 
still  there  came  with  it  long  strings  of  pale  yellow  mucus 
and  choppy  pieces  of  ingesta.  Nothing  further  was  done 
with  the  animal  that  night. 

Tuesday,  10  a.m. — Animal  still  showing  dull  pains.  A 
rectal  examination  was  again  made.  Even  now,  after 
the  lapse  of  seventeen  or  eighteen  hours,  the  rectum  was 
found  full  of  a  faeces-stained  fluid.  The  obstruction  was 
still  present,  hit  perceptibly  softer.  The  irrigation  was 
repeated  in  the  same  manner,  and  followed  by  the  same 
results. 

4  p.m.— Patient  decidedly  easier.  Repeated  the  irriga- 
tion, and  administered  a  stimulant  to  promote  warmth. 
The  animal  was  then  left  for  the  night. 

Wednesday,  g  p.m. — Horse  quite  easy.  He  had  eaten 
a  good  feed,  and  passed  several  heaps  of  faeces  of  normal 
consistence.  From  this  time  he  made  an  uninterrupted 
recovery. 

Remarks. — The  striking  feature  in  these  cases  is  the 
impunity  with  which   large  quantities  of  cold  water  may 


172  THE  COMMON  COLICS  OF  THE  HORSE 

be  injected  without  bad  effects.  As  the  foregoing  case 
illustrates,  it  appears  rather  to  be  productive  of  good. 
The  rise  of  febrile  symptoms  is  effectually  kept  down, 
and  the  rectum  is  prevented  from  attaining  that  degree 
of  horrible  dryness  that  so  commonly  associates  itself 
with  this  type  of  colic.  If  not  directly  reached  by  the 
in-running  stream  of  water,  the  obstruction  appears  to 
become  softened  by  the  large  amount  of  fluid  remaining 
in  the  rectum  immediately  over  it. 

In  obstructive  colics,  occasioned  by  the  accumulation 
of  masses  of  undigested  food,  veterinarians  have  con- 
stantly bewailed  the  fact  that  the  patient  will  not  drink. 
Here  is  a  ready  means  of  pouring  into  his  system  the 
fluid  he  will  not  voluntarily  take.  In  addition  to  the 
mechanical  aid  it  gives,  we  have  the  welcome  signs  of 
active  peristalsis,  induced  by  the  excitant  action  of  the 
cold  water  on  the  intestine  itself  Now  that  I  know  its 
value,  it  surprises  me  that  no  one  seems  largely  to  have 
adopted  the  treatment.  It  is  not  a  great  deal  of  trouble, 
and  its  beneficial  results  are  at  once  apparent. 


CHAPTER  XIV 

THE   SURGICAL   TREATMENT   OF 
INTESTINAL  OBSTRUCTIONS 

At  times,  in  his  treatment  of  colic,  the  veterinarian  is  on 
the  horns  of  a  dilemma.  He  feels  confident  that  he  has 
successfully  diagnosed  intestinal  obstruction  of  such  a 
nature,  and  in  such  a  position,  as  to  render  surgical 
interference  reasonably  warrantable. 

Should  operative  measures  be  advised  early  on  in 
the  case  ?  Should  expectant  treatment  be  first  adopted, 
and  the  operation  be  only  advised  as  a  derniev  ressort  ? 
If  the  first  is  decided  on  the  patient  may  die  from  the 
effects  of  the  operation,  and  the  owner  be  accordingly 
annoyed.  Adopting  the  latter  procedure,  the  patient,  in 
a  state  of  rapid  collapse,  will  not  offer  great  possibilities 
of  the  operation  being  successful. 

Thinking  so,  the  veterinarian  has  been  apt  to  let 
matters  rest,  and  it  was  not  until  1895  ^^at  Professor 
Macqueen,  of  the  Royal  Veterinary  College,  put  the 
matter  upon  a  more  satisfactory  basis.  This  gentleman's 
experiences,  coupled  with  his  exhaustive  searches  into 
veterinary  literature,  led  him  to  the  belief  that  penetra- 
tion of  the  equine  peritoneal  cavity  was  not  so  highly 
dangerous  after  all,  and  that  operations  involving  that 
step  were  quite  safely  within  the  bounds  of  possibility. 


174  THE  COMMON  COLICS  OF  THE  HORSE 

For  the  benefit  of  his  brother  veterinarian,  Professor 
Macqueen  converted  his  beliefs  into  undeniable  facts 
by  the  performance  of  several  interesting  experiments. 
Horses  were  cast  and  anaesthetized.  Suitable  antiseptic 
precautions  were  taken,  and  in  each  case  a  small  por- 
tion of  the  floating  colon  was  exposed.  An  incision  was 
made  through  the  bowel  wall,  its  contents  removed,  the 
wounds  sutured,  and  the  animal  allowed  to  recover. 
Reserving  my  remarks  on  its  practical  utility  for  the  end 
of  the  chapter,  I  will  allow  Professor  Macqueen  to  give 
the  details  of  this  operation  in  his  own  words  : 

^Materials,  mstruments,  etc.,  required. — Four  large  and 
twelve  small  Turkey  sponges,  for  use  inside  the  abdomen 
and  about  the  bowel.  Twelve  yards  of  tarlatan,  cut  into 
two- yard  lengths,  for  packing  round  the  bowel  brought 
outside  the  wound.  Four  sponge  cloths,  for  laying  on 
abdomen  and  thighs  to  catch  dust  during  the  operation, 
to  wipe  the  skin,  and  for  rougher  work  outside  the  wound. 

'  Three  enamelled  iron  trays  to  hold  instruments,  liga- 
tures, and  needles.  Four  zinc  pails  to  hold  hot  water, 
sponges,  lotions,  etc.  One  small  bucket  marked  in  pints 
to  measure  hot  water  for  making  solutions,  etc.  Some 
20  per  cent,  carbolic  soap  for  washing  hands  and  flank 
and  for  shaving.  One  aseptic  scalpel  and  a  razor.  Two 
elbowed  scissors,  sharp  and  blunt  pointed,  to  divide 
muscles,  open  peritoneum  and  bowel.  Two  sponge- 
holding  forceps.  Two  Thornton's  T-shaped  forceps  to 
stop  bleeding  from  skin  or  muscle.  Two  Wells'  catch 
forceps,  and  one  or  two  spring  and  dressing  forceps. 
A  few  straight  and  curved  suture  needles.  Twenty 
milliners'  needles,  straws  No.  5,  for  stitching  the  gut. 
Chinese  twist  for  all  sutures — No.  i  for  the  gut.  No.  3 
for  muscles,  and  No.  6  for  the  skin.  A  fine  trocar  and 
cannula,  to  puncture,  if  necessary,  distended  bowel.     A 


SURGICAL  TREATMENT  175 

convenient  supply  of  hot  water,  and  a  piece  of  fine 
.  muslin,  several  layers  thick,  for  use  as  a  sieve  for  water 
to  be  used  for  lotions  or  for  irrigation.  Chloroform  and 
an  inhaler  with  sponge,  and  some  pure  carbolic  acid  in  a 
graduated  bottle.  For  dressing  the  wound  the  following 
should  be  ready :  Iodoform  and  tannin,  i  to  3  ;  antiseptic 
cotton-wool  and  tow ;  carbolized  gauze ;  a  piece  of 
calico,  6  yards  by  9  inches  ;  roller  bandages,  and  a  few 
safety-pins. 

*  Preparation. — The  small  sponges  may  be  obtained 
ready  for  use  from  any  wholesale  druggist.  They  are 
known  as  Milne's  aseptic  sponges.  Probably  the  large 
sponges  can  be  purchased  in  the  same  condition.  I 
prepared  my  sponges  in  this  way :  After  beating  out  the 
sand  the  sponges  were  placed  for  four  or  five  days  in 
cold  water,  which  was  changed  daily,  then  transferred  to 
a  solution  of  hydrochloric  acid,  an  ounce  to  the  gallon, 
where  they  remained  for  twelve  hours ;  from  this  they 
were  placed  under  the  cold-water  tap,  and  turned  about 
under  a  constant  stream  for  an  hour  or  two ;  then  each 
was  thoroughly  washed  in  plenty  of  hot  water,  squeezed 
as  dry  as  possible,  and  finally  placed  in  5  per  cent, 
carbolic  solution. 

*  The  tarlatan,  cut  into  two-yard  lengths,  was  washed  in 
hot  water  containing  Hudson's  powder,  then  thoroughly 
rinsed,  and  placed  beside  the  sponges  in  carbolic.  The 
sponge  cloths  were  boiled,  rinsed  in  cold  water,  soaked 
in  5  per  cent,  solution  of  carbolic,  and  then  dried. 

'  The  Chinese  twist  was  stretched  by  winding  each 
skein  on  a  bit  of  wood  (3  inches  by  ij  inches),  plunged 
in  hot  water,  and  boiled  for  ten  minutes ;  then  stretched 
again  by  winding  on  another  bit  of  wood,  and  finally 
placed  in  a  wide-mouthed  bottle  containing  5  per  cent, 
solution  of  carbolic  acid. 


T76  THE  COMMON  COLICS  OF  THE  HORSE 

'  The  scissors,  forceps,  needles,  scalpel,  etc.,  should  be 
kept  together  in  a  sheet-iron  case,  which  may  be  placed 
on  a  stove  or  near  a  fire. 

'  After  operation  the  sponges,  instruments,  etc.,  must 
be  cleansed.  The  sponges  and  tarlatan  are  placed 
together  in  cold  water,  which  is  frequently  changed ; 
then  the  sponges  are  transferred  to  hot  water  containing 
washing  soda — 4  ounces  to  the  gallon — and  left  there 
for  a  day.  From  this  they  are  placed  under  the  cold- 
water  tap,  then  washed  separately  in  hot  water,  dried 
in  the  sun,  divested  of  hairs,  and  again  placed  in  5  per 
cent,  carbolic.  The  tarlatan  is  washed  as  before  with 
Hudson's  powder,  dried,  and  placed  beside  the  sponges. 
For  keeping  sponges  and  muslin  a  2-gallon  pail,  with 
hinged  lid,  will  be  found  very  convenient.  The  sponge 
cloths,  after  soaking  in  water,  are  boiled  with  soda, 
rinsed,  and  dried.  The  instruments  are  scrubbed  and 
washed  in  hot  water  containing  Hudson's  powder,  dried, 
and  enclosed  in  the  iron  case,  which  is  then  placed  near 
a  fire. 

'  Preparation  for  Operation. — Before  casting  the  horse,  the 
flank  from  spine  to  groin  and  from  haunch  to  sixteenth 
rib  is  clipped  and  washed.  When  the  horse  is  under 
chloroform  the  flank,  within  2  or  3  inches  of  the 
boundary  marked  by  clipping,  is  shaved  and  disinfected. 
While  these  preliminaries  are  proceeding,  the  pails  and 
trays  are  arranged  and  filled.  All  the  solutions  must  be 
warm,  and  the  water  used  in  their  preparation  passed 
through  muslin.  Pail  No.  i  is  filled  with  5  per  cent., 
and  pail  No.  2  with  2J  per  cent.,  solution  of  carboHc 
acid.  The  trays  are  filled  with  hot  solution  of  the  same 
strength  as  pail  No.  2.  The  sponge  cloths  are  placed  in 
No.  I,  and  kept  there  until  required.  The  sponges  and 
tarlatan,  after  having  been  squeezed  as  dry  as  possible. 


SURGICAL  TREATMENT 


177 


are  placed  in  No,  2.  In  one  tray  are  placed  the 
milliners'  needles,  twelve,  of  which  are  threaded  with 
twist  No.  I ;  another  tray  contains  scissors,  forceps,  and 
scalpel  ;  and  the  third  contains  reserve  instruments, 
suture  needles,  and  twists  Nos.  3  and  6.     Pail  No.  3  is 

Position  of  first  incision  through  the  skin  and 
across  the  fibres  of  the  external  oblique. 


Dotted  line  marking  the 
position  of  secondary 
wound  for  drainage. 


Fig.  12.— Seat  of  Laparo-Enterotomy  (Macqueen's  Operation). 


filled  with  hot  water  for  rinsing  hands  and  instruments ; 
and  pail  No.  4  is  filled  with  boiling  water,  which  is  pro- 
tected from  dust  and  allowed  to  cool.  This  water  will 
be  required  to  wash  the  bowel  after  suture. 

^Abdominal  Incision. — The   linea   alba   offers  the  least 
vascular    and    shortest    route    to    the    interior    of    the 

12 


178 


THE  COMMON  COLICS  OF  THE  HORSE 


abdomen.  Through  an  incision  of  the  white  line  any 
organ  within  the  cavity  can-  be  felt,  the  small  and  large 
intestines   in   part    can   be   seen,    and   to   some    extent 

Skin. 


Cut  fibres  of  ex- 
ternal oblique. 


Second  incision 
parallel  with 
the  fibres  of 
the  intern  a  1 
oblique.  (The 
fibres  of  the 
ransversalis 
can  be  seen 
through  the 
wound). 


Fig.  13 — Operation  Wound  (Laparo-Enterotomy). 

Showing  the  first  incision  through  the  skin  and  across  the  fibres  of 

the  external  obHque.     (Enlarged  from  Fig.  12.) 

portions  of  these  viscera  can  be  withdrawn  ;    but  the 
colic  mesentery  is  too  short  to  permit  the  first  part  of 


SURGICAL  TREATMENT 


[79 


the  floating  colon  to  pass  through  the  wound.  Besides, 
if  the  incision  is  made  at  this  point  the  wound  does  not 
heal  rapidly,  and  adhesion  between  its  peritoneal  surface 
and  omentum  or  bowel  is|a  probable  complication.  In 
the  horse,  incision  of  the  abdomen  an  inch  or  two  to 
the  right  or  left  of  the  linea  alba  is  equally  objectionable. 
When  the  floating  colon  has  to  be  opened,  I  prefer  to  reach 
the  bowel  through  the  flank  (see  Fig.  12,  p.  177).  In  open- 
ing the  flank  I  make  three  wounds  before  touching  the 
peritoneum.  The  first  divides  the  skin,  fascia,  and  external 
ohiique  muscle;  the  second  the  internal  oblique;  and  the  third 
the  transversalis  (see  Fig.  13,  p.  178).  The  first  starts  at  a 
point  4  inches  below  the  lumbar  transverse  processes, 
midway  between  the  angle  of  the  haunch  and  the  last  rib, 
and  passes  downwards  and  forwards  for  7  or  8  inches.  The 
forward  direction  of  this  incision  is  opposed  to  all  teaching, 
but  its  advantage  is  conceivable.  The  upper  hind  limb 
is  unhobbled  and  drawn  backwards.  The  wound  gapes 
and  exposes  the  internal  oblique  muscle,  which  is  then 
cut  with  scissors  in  the  direction  of  its  fibres.  A  similar 
opening  is  made  in  the  transversalis.  The  third  wound 
exposes  a  layer  of  fat  which  is  lined  by  peritoneum ;  this 
is  pierced  with  the  finger,  and  the  opening  is  enlarged 
with  scissors  in  the  direction  of  the  transversalis  wound. 
^Incision  and  Suture  of  the  Bcwel. — So  far  I  have  only 
opened  the  bowel  at  the  middle  of  the  longitudinal  band, 
where  the  wall  appears  strongest  and  most  capable  of 
supporting  sutures  (see  Fig.  14,  p.  180).  With  sharp- 
pointed  elbowed  scissors  the  gut  can  be  punctured  and 
the  wound  extended  without  the  slightest  difliculty.  The 
wound  is  closed  with  sutures  of  prepared  Chinese  twist 
No.  I.  There  are  many  methods  of  suturing  bowel 
wounds,  but  Lembert's  is  the  only  one  of  which  I  have 
experience.     Sutures  applied  by  Lembert's  method  pass 

12 — 2 


i8o 


THE  COMMON  COLICS  OF  THE  HORSE 


through  both  the  serous  and  muscular  coats ;  the  mucous 
membrane  must  not  be  punctured.  The  needle  enters 
^  inch  from  wound,  passes  through  muscle  for  -J-  inch, 
then  pierces  serous  ^  inch  from  the  edge  of  the  wound. 
It  is  then  carried  across  the  wound,  re-inserted  1  inch 
from  edge,  passed  through  muscle  for  i  inch,  and  brought 
out  ^  inch  from  the  wound.  A  glance  at  the  diagram 
(Fig.  14)  will  enable  anyone  to  understand  the  course  of 


Fig.  14.— Lembert's  Sutures  (in  Small  Colon). 

the  needle.  The  sutures  arc  placed  -^  inch  apart  and 
tied  separately.  The  ends  are  shortened  to  within  J  inch 
from  the  knots.  Degive  has  improved  this  method  by 
making  the  sutures  continuous. 

'  Operation. — Cast  the  horse  on  the  left  side  and  give 
chloroform.  Wash,  shave,  and  disinfect  the  flank. 
Spread  sponge-cloths,  wrung  out  of  carbolic  lotion  (5  per 
cent.),  in  front  and  behind  area  of  incision.     Incise  skin 


SURGICAL  TREATMENT  i8i 

and  external  oblique ;  unhobble  upper  hind  limb,  draw 
it  backwards,  and  fix  to'  a  post  or  wall.  Douche  wound 
with  warm  carbolic  lotion  {o.^  per  cent.),  and  stop  bleed- 
ing from  skin  and  muscle.  With  elbowed  scissors  slit 
internal  oblique  muscle  in  the  direction  of  its  fibres,  trim 
the  edges,  and  stop  bleeding.  Snip  transversalis  with 
scissors  and  extend  opening  with  finger,  taking  care  not 
to  puncture  fatty  layer  or  peritoneum.  Examine  wound 
and  check  bleeding.  Sponge  with  warm  carbolic  lotion 
(2J  per  cent.)  and  remove  excess  of  fluid.  When  satis- 
fied that  the  wound  is  "  dry,"  rinse  the  hands,  push 
the  finger  through  fat  and  peritoneum,  and  enlarge 
opening  with  blunt-pointed  elbowed  scissors.  Pass  a 
large  sponge,  wrung  out  of  (2J  per  cent.)  warm  carbolic 
solution,  into  abdomen,  and  get  tarlatan  ready.  Pass  the 
hand  into  abdomen,  bring  out  the  bowel,  and  hold  it 
gently  until  assistant  has  placed  pieces  of  tarlatan, 
moistened  with  warm  carbolic  lotion  (2|  per  cent.),  round 
the  wound.  This  done,  let  the  assistant  take  the  bowel 
between  his  fingers  appHed  like  clamps,  the  hands  resting 
one  in  front,  the  other  behind  the  wound.  Incline  the 
bowel  towards  the  horse's  thigh,  and  slit  the  free  border 
with  scissors.  Remove  contents  and  wash  its  mucous 
lining.  With  a  fresh  sponge  clean  the  edges  of  the 
wound,  and  apply  Lembert's  sutures.  Place  the  stitches 
\  inch  apart,  and  insert  two  or  three  beyond  the 
wound  at  each  extremity.  .Pass  all  the  sutures  before 
tying  any.  Wipe  the  edges  as  tying  proceeds,  and 
shorten  the  suture  ends  to  \  inch  from  the  knot. 
When  the  wound  has  been  closed,  pull  the  bowel 
well  out  of  abdomen,  and  let  assistant  renew  his  hold. 
Carefully  sponge  off  clots,  hairs,  and  suture  ends,  and 
douche  with  boiled  water  that  has  been  allowed  to  cool 
to   about   106°    F.      Remove   packing   from   round   the 


i82  THE  COMMON  COLICS  OF  THE  HORSE 

wound,  let  the  bowel  slip  into  abdomen,  and  withdraw 
the  sponge.  Look  inside,  and,  if  necessary,  pass  in  a 
fresh  sponge  to  take  up  clots  or  fluid.  Adjust  the  edges 
of  transversalis  wound,  and  excise  protruding  fat.  Pass 
two  or  three  sutures  (twist  No.  3)  through  internal 
oblique  muscle,  and  sponge  the  surface  with  carbolic 
lotion.  Re-hobble  upper  hind  limb,  and  bring  edges  of 
external  oblique  together  with  a  few  fine  sutures.  Close 
the  external  wound  with  strong  (No.  6)  twist  sutures 
passed  through  skin  and  muscle,  tied  in  front  or  behind 
the  line  of  union.  Then  slit  skin  and  fascia  downwards 
and  backwards  to  2  inches  from  lower  end  of  first 
incision.  This  will  drain  the  operation  wound.  Sponge 
the  surface  with  carbolic  lotion,  and  let  the  horse  rise. 
Dust  the  flank  with  iodoform  and  tannin,  insert  aseptic 
tow  in  drainage  wound,  and  cover  the  whole  with  car- 
bolized  cotton,  protected  with  four  layers  of  gauze. 
Support  the  dressing  by  winding  calico  round  the  body, 
and  roller  bandages  secured  with  safety  pins.  Muzzle 
the  horse  for  five  or  six  hours,  but  leave  his  head  loose. 
Encourage,  but  do  not  force,  exercise.  For  a  few  days 
restrict  his  diet,  which  ought  to  be  somewhat  laxative. 
Dressings  should  not  be  renewed  until  oozing  occurs, 
then  re-dress,  but  do  not  plug  the  drainage  wound.  The 
dressings  might  be  substituted  with  advantage  by  pitch 
plaster  or  a  mild  blister.' 

Following  closely  the  lines  advocated,  Professor  Mac- 
queen  operated  on  {a)  an  aged  brown  pony  gelding, 
(b)  an  eight-years-old  chestnut  pony  gelding,  and  (c)  an 
aged  brown  nag  gelding,  at  one  of  which  operations  I 
had  the  good  fortune  to  be  present. 

So  far  as  could  be  ascertained,  these  animals  were 
healthy  before  the  experiments. 

Animals  (b)  and  (c)  were  allowed  to  live  sufficiently 


SURGICAL  TREATMENT  183 

long  after  the  operations — twenty-two  and  thirty  days 
respectively — to  prove  the  success  of  the  undertaking. 
They  were  then  chloroformed  to  death,  and  post-mortem 
examinations  made  of  the  carcasses.  In  each  case  the 
result  of  the  autopsy  was  gratifying. 

The  brown  pony  gelding  {a)  was  slaughtered  on  the 
seventh  day  following  the  experiment.  If  I  remember 
rightly,  he  showed  somewhat  peculiar  symptoms  shortly 
after  the  operation.  It  was  difficult,  in  fact,  to  say 
whether  he  was  suffering  from  an  ordinary  sporadic 
attack  of  pneumonia,  or  whether  the  pneumonia  was  of 
a  septic  nature,  caused  by  absorption  from  the  operation 
wounds.  I  think  that  I  may  say  the  result  of  the 
autopsy  on  the  seventh  day  rather  justified  the  assump- 
tion that  the  pneumonia  was  sporadic  in  its  nature,  and 
that  the  operation  was  not  the  cause  of  it. 

We  have  here  three  operations  of  a  serious  nature. 
The  end  result  of  one  may  be  classified  *  doubtful,'  with 
a  leaning  towards  '  favourable  ';  while  the  remaining  two 
may  be  termed  in  the  highest  degree  '  successful.'  The 
surgeon  has  shown  us  that,  so  far  as  the  operation  itself 
is  concerned,  we  have  nothing  to  dread. 

Can  it  be  turned  to  practical  account  ?  One  case  only 
is  on  record  of  the  operation  being  successfully  performed 
for  the  removal  of  a  calculus  or  obstruction  that  was 
actually  giving  rise  to  dangerous  colic.  This  was  by 
Felizet  in  1849.  The  position  of  the  calculus  was  the 
commencement  of  the  small  colon.  Several  other  cases 
are  on  record  where  the  same  operation  has  been 
attempted,  the  animal,  unfortunately,  dying  in  each 
instance.  It  appears  that  in  each  case  the  failure  of  the 
operation  was  directly  attributable  to  its  having  been  too 
long  delayed. 

Several  years  have  now  passed  since  Professor  Mac- 


i84  THE  COMMON  COLICS  OF  THE  HORSE 

queen  performed  these  experim3nts.  Their  practical 
utihty  can  only  be  judged  of  by  what  has  transpired. 
So  far  as  I  am  able  to  trace,  no  successful  removal  of  an 
obstruction  with  the  complete  recovery  of  the  patient 
has  since  been  placed  on  record.  Either  the  present-day 
veterinary  surgeon,  in  spite  of  Professor  Macqueen's 
able  assurance  of  success,  is  not  possessed  of  the  bold- 
ness of  the  old-time  Felizet,  or  he  has  deemed  the 
operation  not  exactly  *  impossible,'  but  '  inadvisable.' 
I  am  loth  to  put  the  paucity  of  recorded  cases  down 
to  apathy  and  want  of  boldness,  and  can  only  conclude 
that  the  veterinarian  has  not  seen  it  practicable  to  put  the 
operation  into  every-day  use. 

The  man  who  first  diagnoses  a  suitable  case,  after- 
wards operates  in  good  time,  and  is  rewarded  by  the  sub- 
sequent recovery  of  his  patient,  will  have  to  be  possessed 
of  an  amount  of  foresight  and  will-power  far  beyond  the 
ordinary. 

In  the  first  place,  he  will  have  to  be  able  to  decide 
quickly  that  the  obstruction  he  is  dealing  with  is  not 
likely  to  surrender  to  milder  measures — surely  a  difficult 
task.  Again,  he  must  be  convinced  that  the  percentage 
of  deaths  from  obstruction  of  the  single  colon  is  heavy 
enough  to  warrant  the  operation  being  immediately 
advised  in  each  and  every  case  that  is  diagnosed.  The 
equine  patient  does  not  live  long  enough  with  obstruction 
to  allow  of  any  delay,  no  matter  how  short.  Untoward 
conditions  in  the  bowel  soon  make  their  appearance,  and 
place  its  wall  in  an  unfit  state  for  surgical  interference. 
If  the  veterinarian  waits  until  the  symptoms  frighten 
him  into  the  operation,  he  has  waited  too  long.  Coupling 
this  need  for  immediate  decision  with  the  fact  that  nearly 
all  veterinary  operations  must  be  regulated  by  strictly 
economic    principles,  it   is  not   surprising  to  learn  that 


SURGICAL  TREATMENT  185 

a  major  operation  of  this  description — one  for  which  a 
large  fee  must  necessarily  be  demanded,  and  one  which 
will  make  or  mar  a  great  deal  of  the  operator's 
reputation — is  severely  relegated  to  the  background  of 
'  possible,'  but  *  inadvisable,'  remedial  measures  in  cases 
of  equine  intestinal  obstruction. 

To  my  own  mind  there  is  only  one  of  the  intestinal 
obstructions  described  in  this  volume  that  is  at  all  likely 
to  warrant  this  extreme  step  being  taken  :  that  is  the 
obstruction  occurring  in  the  small  colon.  That  con- 
clusion is  fairly  justified  by  the  following  considerations  : 

1.  Professor  Macqueen  has  covertly  admitted  that  the 
small  colon  is  the  most  suitable  bowel  to  operate  upon, 
its  comparatively  thick  longitudinal  band  offering  a  suit- 
able position  for  the  incision  and  the  after-placing  of  the 
sutures. 

2.  In  the  present  state  of  our  knowledge,  the  diagnosis 
of  these  obstructions  is  not  sufficiently  clear  to  justify  us 
in  operating  unless  the  obstruction  has  been  positively 
felt  per  rectum.  I  have  already  shown,  in  Chapters  X. 
and  XL,  that  an  obstruction  of  this  size  felt  per  rectmn  is 
most  likely  to  be  in  the  small  colon. 

3.  Should  the  obstruction  be  demonstrated  to  exist  in 
the  large  colon,  we  have  to  face  two  serious  factors 
largely  operating  against  the  chances  of  successful 
surgery  :  {a)  The  extreme  likelihood  of  the  obstruction 
being  of  so  large  a  size  as  to  necessitate  a  very  large 
incision  in  the  bowel  wall,  (h)  The  comparative  thin- 
ness of  the  walls  of  this  portion  of  the  intestinal  tract, 
which  would  render  the  placing  of  safe  sutures  a  matter 
of  considerable  difficulty. 

When  all  is  said,  the  veterinarian  may  remember  this 
much  with  safety :  Whatever  may  be  his  doubts  con- 
cerning his  diagnosis,  whatever  anyone  else  may  urge  to 


i86  THE  COMMON  COLICS  OF  THE  HORSE 

the  contrary,  he  may  be  perfectly  assured — thanks  to 
Professor  Macqueen — that  the  incising  of  the  flank  and 
opening  of  the  bowel  (laparo-enterotomy)  is  attended  with 
no  grave  risk  in  the  horse — that  is,  if  conducted  strictly 
under  modern  antiseptic  precautions,  and  with  a  patient 
still  free  from  symptoms  of  collapse. 

As  illustrative  of  a  suitable  case  for  operative  measures, 

1  would  refer  the  reader  to  a  reported  case  of  Mr.  E.  R. 
Harding,  M.R.C.V.S.,  of  Salisbury  :i 

*  Peculiarly-shaped  Large  Calculus  in  the  Small 
Colon  of  a  Mare. — The  mare  was  taken  ill  on  a  Sunday. 
An  examination  was  made  by  Mr.  Harding.  The  large 
bowels  were  found  full  of  faeces,  and  the  animal  showing 
signs  of  colic.  The  pain  was  not  acute,  and  the  tem- 
perature very  little  disturbed.      The  animal  was  given 

2  grains  of  eserine  without  its  having  the  slightest  effect 
on  the  colic  or  in  producing  defsecation.  Aloes  was  not 
given,  but  the  case  treated  with  stimulants.  During  the 
first  four  days  she  had  intervals  of  pain,  while  at  other 
times  she  was  quiet.  At  no  time  was  the  pain  acute. 
After  Tuesday  the  animal  appeared  to  have  no  pain 
whatever  for  a  week,  but  she  ate  nothing,  and  there  was 
no  movement  of  the  bowels.  The  only  medicine  adniin- 
isteved  was  stimulants,'^  and  warm-water  injections  five  or 
six  times  a  day.  This  went  on  for  eighteen  days,  when 
the  mare  died  during  the  night.  A  post-mortem  revealed 
a  large  calculus  m  the  colon,  and  showed  that  the  actual 
cause  of  death  was  ruptured  colon,  while  an  enormous 
mass  of  ingesta  was  found  in  the  bowels.  The  calculus 
was  3|-' pounds  in  weight,  and  seemed  composed  princi- 
pally of  faecal  matter.  The  animal  had  been  in  the 
owner's  possession  four  or  five  years,  and  had  not  been 
ill  before.' 

There  are  two  things  that  appeal  to  one  in  the  report 
of  that  case.      The  first  is  the  marvellous  manner  in 

1  Veterinary  Record,  vol.  xiv.,  p.  682. 

2  The  italics  are  mine.— H.  C.  R. 


SURGICAL  TREATMENT 


187 


which  it  points  to  the  advantages  of  a  solely  stimulative 
treatment.  It  would  be  hard  to  imagine  an  animal  with 
obstructive  coHc  being  dosed  with  sedatives  and  then 
lingering  on  in  the  same  manner  for  so  long  a  time  as 
eighteen  days.     The   fact  of   the    matter   is   this:    The 


Fig.  15, -Calculus  obstructing   Small   Colon    (AIr.  Harding's 
Case). 


general  abandonment  of  sedatives  in  veterinary  equine 
practice  would  undoubtedly  lead  to  the  better  diagnosis 
of  colic  troubles.  I  feel  that  it  has  already  increased 
my  own  powers  in  that  respect,  and  what  it  will  do  for 
me  it  will  do  for  others. 


i88  'J^iiE  COMMON  COLICS  OF  THE  HORSE 

Secondly,  one  is  forcibly  struck  by  the  grand  oppor- 
tunity this  subject  would  have  afforded  for  operative 
measures  if  only  a  successful  diagnosis  could  have  been 
made  during  life. 

I  would  fain  hope  that  in  this  way  the  future  success 
of  laparo-enterotomy  lies.  It  may  be  that  a  long  series 
of  colic  cases  treated  without  sedatives  will  eventually 
lead  to  a  greater  and  more  frequent  exactness  in  the 
diagnosis  of  these  obstructions ;  that  being  done,  the 
operation  will  follow  naturally.  This  cannot  be  expected 
until  a  solely  stimulant  treatment  is  adopted  by  a  large 
number  of  veterinary  surgeons,  and  the  information 
derived  from  their  cases  carefully  chronicled. 


CHAPTER   XV 

INTESTINAL    TYMPANY:    WIND     COLIC, 

FLATULENT    COLIC,  HOVEN, 

TYMPANITES,  ETC. 

Definition. — That  condition  produced  by  the  evolution 
of  gases  in  abnormal  amount  in  some  part  of  the  intes- 
tinal canal,  with  consequent  over-distension  of  the  portion 
in  which  it  occurs.  In  the  horse  the  common  seats  of 
tympany  are  the  stomach  and  the  large  colon.  The 
former  we  have  already  disposed  of  in  a  previous  chapter, 
and  it  now  remains  to  give  a  fuller  consideration  to  this 
particular  condition  when  confined  to  the  intestines. 

Causes. — These  I  have  already  enumerated  at  length 
in  Chapter  VII.  On  that  account,  no  mention  here 
beyond  a  brief  summary  is  necessary.  Dietetic  errors 
again  come  to  the  front.  Probably  the  most  common 
cause  of  all  is  the  gorging  with  young  herbage  when  the 
animal  is  first  turned  out  in  the  spring  after  a  winter 
in  the  stable.  Young  growing  corn,  clover,  vetches, 
and  foods  excessively  mouldy  may  all  be  regarded  as 
dangerous.  One  of  the  worst  cases  I  have  encountered 
myself  was  brought  about  by  the  owner  feeding  the 
animal  on  raw  potatoes.  The  use  of  new  oats,  wheat, 
and  steeped  foods  that  have  been  allowed  to  go  sour,  is 
also  a  common  cause  of  this  condition.     Reports  of  cases 


I90  THE  COMMON  COLICS  OF  THE  HORSE 

also  show  this  disorder  to  sometimes  be  occasioned  by 
animals  eating  large  quantities  of  mangolds,  swede, 
turnips,  or  other  roots.  Putting  to  work  too  soon  after 
a  heavy  meal,  or  watering  and  feeding  too  freely  when 
exhausted,  are  also  likely  factors  in  its  causation. 

A  dangerous  form  of  this  derangement  is  often  met 
with  by  those  who  live  in  marshy  districts.  The  coarse 
grasses  and  succulent  forms  of  herbage  that  flourish 
down  by  the  water's  edge  appear  peculiarly  liable  to 
bring  on  an  attack.  When  half  dried,  these  marshy 
grasses  seem  even  more  dangerous  still,  and  many  a 
case  of  severe  intestinal  tympany  is  directly  traceable 
to  a  meal  of  what  is  commonly  known  as  '  dykeings  ' — 
heaps  of  partly-dried  vegetation  mown  from  close  to  the 
water-side  during  the  process  of  cleaning  the  drain.^ 

Williams,  in  his  description  of  this  complaint,  says  : 
'  Tympanites  may  arise  independently  of  any  cognizable 
extrinsic  cause.  Occurring  during  the  process  of  another 
disease,  it  is  always  to  be  looked  upon  as  indicative  of 
a  very  grave  condition,  that  the  animal  powers  are 
so  exhausted  as  to  be  bordering  upon  dissolution,  and 
becoming  amenable  to  chemical  laws.  Tympanites  also 
occurs  in  obstructions  of  the  intestinal  canal  from  calculi, 
tumours,  or  other  mechanical  causes,  and  generally  indi- 
cates the  approach  of  death.'^ 

Symptoms. — The  veriest  tyro  cannot  fail  to  appreciate 
at  their  true  value  the  indications  of  abdominal  tympany* 
As  might  be  expected,  the  most  prominent  symptom  is 
a  manifest  drum-like  enlargement  of  the  belly.  The 
skin  and  abdominal  muscles  become  enormously  tense, 
and  resonance  is  obtainable  on  percussion.     In  addition 

1  In  the  Fens  'drain'  is  simply  another  word  for  'dyke,'  or 
artificial  water-course.     In  no  way  does  it  signify  sewer. — H.  C.  R. 

2  '  Principles  and  Practice  of  Veterinary  Medicine,'  p.  555. 


INTESTINAL  TYMPANY  igi 

to  this,  all  the  usual  symptoms  of  '  colic  '  are  well  in 
evidence.  The  animal  walks  round  and  round,  paws 
alternately  with  the  fore-feet,  and  makes  frantic  kicks  at 
the  belly  with  the  hind. 

In  a  mild  case  the  tympany  is  plainly  most  noticeable 
in  the  right  flank.  When,  however,  the  abdominal 
enlargement  is  great,  it  is  difficult  indeed  to  fix  it  in  any 
particular  position.  When  distension  is  extreme,  rolling 
is  not  freely  indulged  in,  and  the  animal  lies  down  only 
with  great  care.  Other  manifestations  show  the  pain  to 
be  extreme.  The  breathing  is  tremendously  accelerated, 
coming  and  going  in  short,  fitful  gusts,  broken  every 
now  and  again  by  a  short-drawn  sigh.  The  nostrils  are 
dilated,  the  pulse  small,  weak,  and  greatly  quickened, 
and  the  visible  mucous  membranes  highly  injected. 
The  temperature  is  commonly  raised  about  2°  F.  The 
ears  and  extremities  grow  deathly  cold.  Patchy  per- 
spirations cover  the  neck,  the  shoulders,  and  the  flanks, 
and  the  whole  condition  indicates  a  case  of  the  utmost 
gravity.  It  is  plain  to  even  the  most  ignorant  that 
unless  the  animal  be  given  speedy  reHef  he  will  soon 
succumb.  Even  now  the  accumulated  gases  are  pressing 
heavily  on  the  diaphragm,  and  seriously  impeding  the 
acts  of  respiration.  The  consequent  deoxygenated  and 
gas-poisoned  state  of  the  blood  renders  the  bodily  tone 
bad  indeed,  and  points  to  no  sign  of  spontaneous  recovery 
on  the  part  of  the  animal  economy  itself. 

Diagnosis. — This  is  simple.  The  abdominal  enlarge- 
ment and  the  evidence  it  yields  on  percussion  sufficiently 
point  out  the  nature  and  seat  of  the  trouble.  It  must  be 
remembered,  however,  that  tympany,  when  restricted 
solely  to  the  stomach,  will  also  give  rise  to  apparent 
intestinal  distension — the  abdomen  in  both  cases  is 
swollen.     Nevertheless,  its  true  nature  is  quickly  ascer- 


192  THE  COMMON  COLICS  OF  THE  HORSE 

tained.  When  the  flatulence  is  confined  to  the  intes- 
tine, there  will,  of  course,  be  an  entire  absence  of  such 
symptoms  as  I  have  put  down  as  diagnostic  of  gastric 
tympany.  The  regurgitations  of  the  oesophagus,  the 
attempts  at  vomition,  the  trickling  ingesta  from  the 
nostrils,  and  the  gurgling  noises  in  the  region  of  the 
trachea,  are  all  wanting.  Should  there  be  doubt,  which  I 
do  not  for  a  moment  think  possible,  a  rectal  examination 
will  soon  dispel  it. 

Prognosis — Unless  it  be  a  concomitant  of  some  more 
serious  condition,  a  favourable  verdict  may  usually  be 
indulged  in — that  is,  if  the  case  is  seen  early.  It  is  well, 
however,  to  hold  back  one's  prognosis  of  these  cases 
until  the  operation  of  puncturing  the  bowel  has  been 
performed  and  its  results  noticed.  The  extreme  pain, 
the  suffocating  pressure  of  the  distended  intestines  upon 
the  diaphragm,  and  the  semi-intoxication  induced  by  the 
absorption  of  the  gases,  all  tend  to  mask  the  significance 
of  the  pulse  and  other  symptoms.  Once  the  greater  part 
of  this  is  relieved  by  the  trocar,  the  veterinary  attendant 
is  in  a  far  better  position  to  give  a  correct  forecast.  If, 
after  this  operation  is  performed,  the  pulse  still  con- 
tinues a  running-down  character,  and  the  symptoms 
of  pain  do  not  abate,  the  case  is  to  be  regarded  as 
serious. 

Treatment. — Taking  the  remedial  measures  in  the 
order  of  their  importance,  I  think  prior  place  should  be 
given  to  surgical  interference.  Considering  its  value  and 
comparative  simplicity,  it  is  surprising  that  the  operation 
of  puncturing  the  bowel — technically  known  as  *  entero- 
centesis' — should  have  fallen  into  the  desuetude  it  did. 
From  almost  the  earliest  times  of  which  we  have  any 
record  it  has  been  recommended  by  first  one  writer  and 
then  the  other.     Vegetius,  in  the  fourth  century,  advises 


INTESTINAL  TYMPANY  1^3 

its  adoption,  giving  minute  instructions  as  to  the  seat  of 
the  operation — in  this  case,  the  Hnea  alba,  four  fingers' 
breadth  behind  the  navel — and  suggesting  the  instru- 
ments to  be  employed.  Again,  I  find  mention  of  it  in  an 
old  volume  I  have  before  me  as  I  write,  written  by  one 
Leonard  Mascall,  in  the  time  of  good  Queen  Bess,  and 
published  in  1600.     These  are  the  words  : 

*  For  a  horse  that  is  swolne  with  much  wind  in  his 
body.  Some  horse  with  eating  certaine  windy  meate  or 
such  herbs,  will  be  so  swolne  there  with  as  though  his 
belly  wold  burst,  and  then  he  will  eat  no  meat,  but  stand 
and  hang  downe  his  head,  ready  to  fall,  and  so  die,  if  he 
have  not  speedie  help.  When  ye  shall  see  any  horse  so, 
the  next  remedy  as  I  can  learne,  is  :  ye  shall  take  a  sharp- 
pointed  knife,  or  bodkin,  and  arme  it  so  with  some  stay, 
that  it  go  not  too  deep,  for  piercing  his  guts.  Then 
strike  him  therewith  through  the  skin  into  the  body, 
before  the  hollow  place  of  his  haunch  bone,  halfe  a  foote 
beneath  the  backe  bone,  and  the  winde  will  come  out 
thereat.  Then  if  ye  put  a  hollow  quill  therein  (or  some 
feather  to  keep  it  open  awhile),  the  winde  will  voyd  the 
better  and  so  heale  againe  .  .  .  this  hath  bene  prooved 
the  best  remedie  to  save  your  horse  or  ox.' 

In  1656  mention  is  made  of  it  by  Markham,  and  in 
1 7  76  we  find  it  practised  for  the  relief  of  intestinal  tympany 
by  Roem  of  Dresden.  The  years  1781  and  1834  reveal 
the  operation  as  still  in  existence. 

Coming  to  more  modern  times,  we  find  it  revived  in 
this  country  by  Stewart  of  Glasgow,  in  1836,  and  meet 
with  reports  of  successful  cases  in  1877  and  1879  by  T. 
H.  Merrick  of  Northampton  ;  Alexander  Harthill,  Louis- 
ville, Kentucky;  and  the  late  Captain  Russell  of  Grantham. 
As  a  matter  of  fact,  I  think  I  may  say  with  safety  that 
it  is  only  quite  within  recent  years  that  enterocentesis 

13 


194  ^^^  COMMON  COLICS  OF  THE  HORSE 

has  received  the  amount  of  attention  it  merited,  and  been 
admitted  into  the  ranks  of  useful,  every-day  operations. 
Even  now  I  am  afraid  that  there  are  not  a  few  who  look 
upon  this  simple  means  of  affording  relief  with  a  certain 
amount  of  awe. 

Personally,  I  have  been  in  the  habit  of  using  the  trocar 
and  cannula  in  these  cases  for  several  years.  As  a  result, 
one  untoward  case  has  fallen  to  my  lot.  The  animal 
afterwards  developed  unmistakable  symptoms  of  peri- 
tonitis. Fortunately  he  recovered.  In  one  way  the 
case  was  a  lesson  to  me.  I  had,  in  consequence  of  con- 
stantly employing  it,  grown  to  hold  the  operation  in  a 
certain  amount  of  contempt,  and  must  confess  to  having 
grown  somewhat  careless  as  to  the  matter  of  cleanliness. 
That  case  pointed  out  to  me  the  absolute  necessity  for 
a  scrupulous  care  of  the  trocar  and  cannula.  It  is  not 
sufficient  to  have  it  apparently  clean — it  must  be  anti- 
septically  spotless. 

No  matter  what  care  is  taken  of  the  instrument,  a 
rather  more  common  sequel  to  this  operation  than  the 
above  occurs  in  the  appearance  of  a  small  abscess  at  the 
seat  of  puncture.  Probably  even  the  occasional  appear- 
ance of  this  small  trouble  would  also  be  done  away  with 
if  the  spot  to  be  punctured  were  first  rendered  aseptic, 
in  like  manner  to  the  instrument,  a  procedure  that  the 
exigencies  of  the  case  do  not  always  allow  of. 

With  regard  to  the  seat  of  operation,  there  is  a  general 
consensus  of  opinion  favouring  the  right  flank,  at  a  point 
equidistant  from  the  last  rib,  the  anterior  angle  of  the 
ilium,  and  the  transverse  processes  of  the  lumbar 
vertebrae.  As  a  matter  of  fact,  any  position  in  the  right 
or  left  flank  that  offers  resonance  on  percussion  may  be 
tapped  with  benefit.  Preference,  however,  should  always 
be  given  to  the  right,  as  the  mere  fact  of  the  colon  and 


INTESTINAL  TYMPANY  195 

caecum  being  fixed  there  renders  that  position  always  the 
most  Hkely  to  give  certain  results. 

Failing  to  obtain  flatus  on  the  right  side,  the  left  should 
next  be  tried.  Unrewarded  by  a  rush  of  air  from  one 
spot,  it  sometimes  happens  that  a  second  puncture  in 
the  same  region,  only  i  or  2  inches  removed  from  the 
seat  of  the  first,  is  followed  by  a  ready  and  voluminous 
outrush.  That  being  so,  when  once  the  surgeon  has 
diagnosed  tympany,  he  should  not  desist  from  his  attempt 
to  give  the  gases  outlet  until  he  has  punctured  both  the 
right  and  left  flanks — if  necessary,  in  more  places  than 
one. 

The  trocar  should  be  at  least  6  to  8  inches  in  length, 
and  the  cannula  vary  from  -J  to  -^^  inch  in  diameter. 

Considerable  difference  of  opinion  exists  as  to  the 
portion  of  intestine  punctured.  I  do  not  think  there  is 
much  room  for  doubt.  In  the  vast  majority  of  cases  it 
is  certainly  some  portion  of  the  large  colon. 

As  illustrating  the  rehef  afforded  by  puncturing  the 
bowel,  I  give  a  digest  of  a  case  reported  by  Mr.  T.  H. 
Merrick,  of  Northampton  :^ 

*  On  July  TO,  about  noon,  I  was  summoned  to  a  cart 
mare.  The  messenger  informed  me  that  she  was  in 
great  pain,  and  very  much  "  blown."  I  found  her  to  be 
suffering  from  an  acute  attack  of  tympanites,  the 
abdomen  being  greatly  distended.  The  mare  was  first 
observed  to  be  unwell  in  the  morning  about  four  o'clock, 
when  the  horsekeeper  went  to  fetch  her  from  the  field. 
She  was  in  so  much  pain  that  it  was  with  difficulty  that 
he  got  her  home.  On  my  arrival  the  mare's  pulse  was 
very  weak  and  indistinct,  and  numbered  80  per 
minute ;  the  mucous  membranes  were  much  injected ; 
the  surface  of  the  body  and  extremities  cold  ;  quickened 
respiration,  and  great  uneasiness.     I  administered   the 

1  Veterinary  Journal,  vol.  v.,  p.  316. 

13 — 2 


196  THE  COMMON  COLICS  OF  THE  HORSE 

usual  remedies,  but  failed  to  give  her  relief;  indeed,  she 
got  rapidly  worse,  and  became  so  distressed  and  helpless 
that  I  was  afraid  she  would  fall.  I  therefore  determined 
on  puncturing  the  intestine.  The  accumulated  gas 
rapidly  escaped,  and  the  abdomen  quickly  subsided. 
The  relief  afforded  in  a  few  minutes  was  most  satis- 
factory. All  symptoms  of  pain  immediately  ceased.  In 
the  course  of  two  hours  the  pulse  became  distinct,  and 
the  mare  commenced  to  feed.' 

The  usual  course  in  the  development  of  the  abscess 
following  this  operation  is  well  described  by  the  late 
Captain  Russell,  of  Grantham. ^     He  says  : 

*  On  November  20  my  attention  was  directed  to 
the  post  horse  at  the  George  Hotel,  upon  which  I 
had  operated  for  tympany  on  October  26,  as  he  had 
lately  appeared  stiff  in  his  movements  and  out  of 
sorts.  On  my  seeing  him  and  removing  his  clothing,  I 
perceived  a  large  swelling  upon  his  flank,  about  where 
the  first  puncture  of  the  trocar  had  been  made.  On 
examining  this  swelling,  I  fancied  I  could  feel  deep- 
seated  fluctuation,  and  feeUng  sure  I  had  an  abscess  to 
deal  with,  I  ordered  it  to  be  well  fomented  for  a  day  or 
two  to  endeavour  to  get  it  to  point  externally.  On 
the  23rd,  however,  finding  it  made  no  progress  externally, 
I  examined  it  with  an  exploring  needle,  when  at  a  depth 
of  2  inches  I  came  upon  pus.  Having  made  a  good 
opening,  about  a  quart  of  creamy  pus  escaped.  The 
case  has  gone  on  well,  and  the  animal  was  discharged 
to-day,  December  6,  convalescent' 

Having  removed  the  gases  present  in  the  bowel,  we 
have  two  other  matters  to  consider  :  Firstly,  the  preven- 
tion of  the  further  evolution  of  gases;  secondly,  the 
removal  of  the  cause. 

The  first  of  these  is  to  be  brought  about  by  introducing 
into  the  bowel  some  form  of  antiseptic,  or  rather  anti- 

^   Veterinary  Journulf  vol.  viii.,  p.  4. 


INTESTINAL  TYMPANY  ^9l 

zymotic,  in  order  to  prevent  further  fermentation.  If 
the  colon  followed  immediately  upon  the  stomach,  the 
treatment  already  recommended  for  gastric  tympany 
would  do  equally  well  here.  It  must  be  remembered, 
however,  that  all  remedies  administered  per  ovem  will 
first  have  to  pass  through  the  small  intestines  before  they 
can  reach  the  seat  of  mischief,  and  that  the  presence  of 
large  quantities  of  food  in  the  stomach  and  fore  part  of 
the  intestines  will  proportionately  nullify  their  action. 
It  follows  from  this  that  administration  of  the  anti- 
zymotics  by  the  mouth  is  not  the  readiest  route,  and 
that  their  direct  injection  into  that  part  of  the  intestine 
visibly  affected  would  be  far  more  likely  to  be  followed 
by  good  results. 

This  is  the  method  of  operating :  The  bowel  is  first 
punctured,  in  the  region  of  the  flank,  with  an  ordinary 
trocar  and  cannula.  After  the  escape  of  the  gases,  the 
antizymotic  determined  on  is  injected,  by  means  of 
Toope's  injection  cannula,  directly  into  the  intestine.^ 
This  generally  proves  effectual  in  staying  the  re-forming 
of  gas,  and  the  further  treatment  of  the  case  will  run  on 
ordinary  lines. 

Useful  antizymotics  for  this  purpose  are  carbolic  acid, 
Jeyes'  fluid,  boracic  acid,  hyposulphite  of  soda,  turpen- 
tine, lysol,  etc. 

Probably  the  most  simple  and  effective  of  these  is 
carbolic  acid,  and  it  may  safely  be  injected  in  i  to  6 
or  8  drachm  doses,  when  freely  diluted  with  w-ater. 
Four  drachms  to  the  pint  will  be  found  a  serviceable 
solution.  When  used  in  stronger  solutions,  or  injected 
cold,  it  is  likely  to  set  up  a  somewhat  alarming  attack  of 

1  This  may  also  be  quite  easily  done  with  an  ordinary  small 
trocar  and  cannula,  using  a  Higginson's  syringe,  with  milking 
syphon  attached,  to  inject  the  fluid. 


198  THE  COMMON  COLICS  OF  THE  HORSE 

shivering.  Even  this,  however,  appears  to  quickly  pass 
off,  and  leaves  no  after  ill-effects.  In  addition  to  its 
property  of  staying  fermentation,  the  carbolic  acid  acts 
somewhat  as  a  local  anaesthetic,  and,  without  exerting  a 
general  sedative  action,  serves  to  allay  pain  in  that 
portion  of  bowel  with  which  it  comes  in  contact. 

Professor  O.  C.  Bradley,  while  in  charge  of  the  New 
Veterinary  College  Infirmary,  reports  three  cases  in 
which  this  treatment  was  adopted.  Two  of  these  I  give 
below  : 

1.  '2  p.m.  —  Bay  cart  gelding  admitted.  Colicky 
symptoms,  much  tympany.  Punctured,  and  injected 
4  drachms  of  carbolic  acid  in  i  pint  of  water. 

'  2  pjn. — Much  better.  No  recurrence  of  tympany, 
pulse  65. 

'^p.vi. — Still  improving,  colicky  symptoms  have  dis- 
appeared, pulse  and  respiration  normal ;  continued 
improving.' 

2.  '  6  a.m. — Black  cart  mare  admitted.  Great  pain, 
very  tympanitic;  pulse  weak,  respiration  much  ac- 
celerated. Punctured,  and  injected  2  drachms  of  carbolic 
acid  in  solution.     Morphine  hypodermically. 

'  6.30  a.m. — Easier.     Pulse  70. 

'  8  a.m. — Again  tympanitic  and  very  restless.  Punctured 
again,  and  injected  3  drachms  of  carbolic  acid  in  i  pint 
of  water. 

<  9  a.m. — Better.  Pulse  60  and  stronger,  respirations 
slower.     Has  stopped  walking  about.' 

The  removal  of  the  cause  is  clearly  to  be  brought 
about  by  the  administration  of  a  purgative.  The  fer- 
mentation has  evidently  been  occasioned  by  the  ingestion 
of  unsuitable,  mouldy,  or  imperfectly  masticated  food. 
The  sooner  this  gains  exit  from  the  body  the  better  for 
our  patient.  Personally,  I  am  not  always  disposed  to 
wait  for  the  action  of  an  ordinary  cathartic.  Having  dis- 
posed of  the  gases  already  present,  and  ascertained  that 


INTESTINAL  TYMPANY  199 

the  patient's  condition  will  allow  of  it,  I  prefer  to  inject 
hypodermically  ij  to  2  grains  of  eserine  sulphate.  The 
bowels  soon  respond,  the  offending  materials  are  quickly 
voided,  and  the  patient,  after  the  lapse  of  an  hour,  is  left 
free  from  the  probability  of  another  attack. 

Frequently  this  is  all  that  is  necessary,  and  the  need 
for  intra-intestinal  injections  of  carbolic  acid  is  thus  dane 
away  with.  Should  the  eserine  fail  to  act,  and  the  gases 
commence  to  reaccumulate,  there  is  then  time  for  the 
carbolic  acid  injection  to  be  administered. 

From  what  I  have  written,  1  do  not  wish  the  reader 
to  infer  that  I  absolutely  discountenance  the  administra- 
tion of  remedies  by  the  mouth  in  this  form  of  colic. 
Sooner,  I  consider  it  better  to  *  have  two  strings  to  one's 
bow,'  and,  even  whilst  adopting  the  lines  I  have  recom- 
mended, to  still  continue  administering  the  usual 
stimulants  and  antispasmodics  in  the  form  of  balls  or 
drenches. 

Again,  however,  this  time  in  company  with  others,  I 
place  the  most  severe  strictures  upon  the  use  of  sedatives. 
The  cause  of  the  tympany  is  the  presence  of  fermenting 
materials  in  the  intestine.  There  is  no  just  reason  for 
locking  them  there  by  the  injudicious  use  of  anodynes. 
The  reverse  is  the  case,  and  every  medicine  administered, 
save  such  as  is  purely  antizymotic  in  its  action,  should 
be,  in  some  form  or  other,  essentially  stimulative.  The 
use  of  enemas  is  again  indicated,  and  the  patient  should 
be  well  rugged  down  in  order  to  promote  warmth. 
Treated  on  the  above  lines,  ordinary  cases  of  intestinal 
tympany  will  quickly  respond,  and  offer  no  great  amount 
of  anxiety. 


CHAPTER  XVI 

ENTERITIS:  INFLAMMATION  OF  THE 
BOWELS 

Definition. — Colic  resulting  from  a  morbid  condition  of 
the  intestinal  coats,  manifested  by  extreme  and  con- 
tinuous pain,  and  characterized  by  its  rapid  course  and 
great  fatality. 

Regarded  in  the  light  of  a  simple  inflammation,  the 
term  *  enteritis  '  is  evidently  a  misnomer,  so  far  as  our 
knowledge  of  equine  cases  leads  us.  The  post-mortem 
examination  of  the  intestines  tends  more  to  point  to  the 
fact  of  its  being  a  general  bacterial  infection  of  the  blood- 
stream, commencing  from  the  intestines. 

What  draws  us  to  this  conclusion  ?  I  can  better  lead 
up  to  it  by  quoting  at  length  from  a  paper  by  Mr.  Cun- 
ningham, of  Slateford  •? 

*  What  is  this  inflammation,'  he  asks — '  this  haemor- 
rhagic  inflammation  of  the  bowels  ?  A  favourite  cob  has 
been  working  hard,  he  is  laid  off  lame,  and  your  man  is 
very  kind  to  him,  and  at  night  you  are  suddenly  sum- 
moned to  find  the  cob  that  has  carried  you  so  long, 
and  which  you  know  has  never  had  a  touch  of  colic  in 
his  life,  posting  on  in  two  short  hours  to  its  end.  A 
farmer  buys  a  horse,  young  and  cheap,  in  poor  condition  ; 
*  The  Vtterinanun,  vol.  lix.,  p.  45. 


ENTERITIS  20I 

he  is  good  to  it ;  it  does  well  and  thrives.  He  is  proud 
of  his  bargain,  and  suddenly  on  the  road  it  takes  ill,  and 
in  a  couple  of  hours  you  tell  him  to  prepare  for  the  worst, 
for  though  his  horse  will  live  to  the  morning,  it  will  cer- 
tainly die.  A  horse  passes  your  place  with  his  load  at 
nine  o'clock  in  the  morning,  goes  three  miles,  is  seized, 
returns,  and  by  twelve  o'clock  lies  a  carcass  in  your  box, 
after  a  few  hours'  ceaseless  agony.  This  is  worse  than 
cholera.  What  is  this  disease  ?  You  examine  the 
carcass,  and  find  the  veins,  superficial  and  deep,  filled 
with  black,  fluid,  tarry-looking  blood;  the  abdomen 
quarter  full  of  thin,  watery,  dark-purple,  or  rusty- 
coloured  serum ;  the  stomach  and  bowels  with  consider- 
able contents,  but  not  more  than  many  a  healthy  horse 
in  full  feeding.  The  mucous  membrane  of  stomach 
congested,  and  its  villous  portion  inflamed  and  eroded  ; 
the  secretions  sour  and  acid,  and  their  contents  acrid  and 
high-coloured.  Rectum  not  much  amiss,  but  the  caecum 
and  colon  tell  another  tale.  Purple-looking,  black,  and 
dirty- coloured  inside,  thickened  and  swollen  to  |-  inch 
or  I  inch  in  thickness,  with  contents  partly  solid  and 
partly  fluid  and  purple-coloured,  we  find  in  them  the  true 
seat  of  this  haemorrhagic  inflammation. 

'  Take  a  piece  of  healthy  large  intestine,  examine  it 
carefully,  and  you  find  it  is  about  ^  inch  thick,  the 
muscular  and  peritoneal  coats  are  firmly  attached  and 
adherent  to  each  other,  while  the  internal  mucous  is 
loosely  attached  by  cellular  tissue  to  the  muscular,  with 
a  considerable  amount  of  fat  interposed,  forming  a  sort 
of  cushion  or  bed,  in  which  the  lacteals  and  blood- 
vessels may  lie  and  ramify.  All  the  three  coats  are  pale 
and  destitute  of  high  colouring. 

'  Take  an  inflamed  piece  of  large  intestine,  dissect  it 
carefully.     You    find   ^   or   ^    inch,    or    even    i   inch  in 


202  THE  COMMON  COLICS  OF  THE  HORSE 

thickness,  firm  and  dense,  and  almost  hard  to  the  feel. 
The  peritoneal  and  muscular  coats  still  adhere  closely, 
but  they  are  thickened  and  swollen,  and  soaked  with 
effusion.  Still,  they  do  not  appear  to  be  acutely  or 
actively  inflamed.  The  mucous  coat  is  black  or  dark- 
purple  coloured,  the  seat  of  the  most  intense  and 
evidently  acute  (or  it  may  be  passive)  inflammation,  but 
still  not  much  thickened;  its  inner  lining  is  black  and 
dirty-coloured,  studded  with  minute  openings,  while  the 
space  between  the  mucous  and  muscular  layers  is  filled 
and  gorged  and  swelled  with  effusion,  the  chief  cause  by 
far  of  the  increased  thickness  of  the  bowel,  and  the 
effusion  is  clear,  not  dark-coloured  at  all ;  while  in  the 
peritoneal  folds,  connecting  the  divisions  of  the  gut, 
lymph,  watery  but  clear  and  amber-coloured,  as  from  a 
pleuro-pneumonia  lung,  may  be  found  in  abundance. 

'  If  this  is  simple  acute  inflammation,  where  in  the 
animal  economy  have  we  another  example  of  such  rapid, 
fatal,  and  extraordinary  results  in  the  space  of  a  few 
hours  from  simple,  pure,  acute  inflammation,  and 
nothing  else  ? 

'  Is  it  due  simply  and  solely  to  the  presence  and 
mechanical  irritation  produced  by  large  quantities  of 
indigested  material  in  the  organs  ?  Then,  surely,  a 
horse  with  a  13-pound  dust-ball,  or  one  packed  with 
fodder  beside,  should  be  its  readiest  victim.  But  we 
know  that  such  is  not  the  case.  Is  embolism  the  cause  ? 
I  believe,  in  one  or  two  instances,  one  might  be  justified 
in  saying  so.  Is  it  anthrax  ?  I  do  not  think  the  lesions 
justify  that  conclusion.  Is  twist  or  displacement  the  key 
to  the  mystery  ?  I  believe  in  some  this  does  supply  the 
key,  and  that  some  of  the  so-called  cases  of  inflamed 
bowels  are  simply  cases  of  twist  or  displacement ;  but, 
on  the  other  hand,  of  the  many  cases  I  have  examined 


ENTERITIS 


203 


after  death,  in  only  a  few,  comparatively,  have  I  been  able 
to  trace  any  distinct  twist,  intussusception,  or  strangula- 
tion.' 

Causes.  —  Seeing  that  nothing  is  clear,  we  can  only 
reason  by  analogy.  We  know  that  in  at  least  one  other 
disease  such  appearances  as  are  revealed  in  a  post- 
mortem of  a  case  of  enteritis  are  certainly  caused  by  a 
bacterial  invasion  of  the  intestinal  bloodvessels.  We 
also  know  that  the  symptoms  closely  correspond,  that 
the  pain  is  just  as  agonizing,  and  that  the  illness  is  just 
as  fatally  rapid.     I  am  referring  to  anthrax. 

When,  after  the  experience  of  such  a  case,  one  meets 
with  another  in  which  the  onset  is  similar,  the  symptoms 
almost  identical,  the  issue  just  as  much  a  foregone  con- 
clusion, and  the  post  -  mortem  appearances  hardly 
distinguishable,  one  may  be  excused  for  referring  it  to 
a  similar  cause.  In  the  first  case  the  cause  has  been 
carefully  and  indisputably  shown  to  be  anthrax. ^  In  the 
second,  the  most  painstaking  search  fails  to  reveal  its 
presence.  We  know  that  the  second  case  is  not  anthrax, 
for  the  methods  that  revealed  it  once  should  expose  it  a 
second  time,  and  are  therefore  able  to  assume  that  its 
cause  must  be  a  rapid  invasion  of  the  lacteals  and  blood- 
stream by  some  germ  or  other  as  yet  undemonstrated. 

Allowing  this  to  be  the  fact,  it  does  not,  for  a  moment, 
detract  much  from  what  other  writers  have  put  down  as 
the  usual  causes.  Take,  for  instance,  such  commonly 
quoted  causes  as  over-fatigue,  cold  from  exposure,  and 
washing  the  belly  with  very  cold  water  when  the  animal 

1  I  am  able  to  vouch  for  the  truth  of  that  statement  from  the 
experience  of  a  case  that  occurred  in  my  own  practice.  The  animal 
died,  showing  every  symptom  of  so-called  enteritis.  The  case  was 
diagnosed  as  such  and  treated  as  such.  As  a  result  of  the  post- 
mortem, I  was  able  to  definitely  demonstrate  the  presence  of  the 
Bacillus  anthracis  in  the  blood.— H.  C.  R. 


204  THE  COMMON  COLICS  OF  THE  HORSE: 

is  heated.  It  is  conceivable  that  either  of  these  factors 
would  tend  to  lower  the  body  vitality,  and  that  any  pre- 
disposition there  may  have  been  would  be  hurried  into 
an  attack  by  their  aid,  such  predisposition  being  the 
presence  of  the  necessary  virus  in  the  intestinal  tract, 
and  some  condition  of  the  bowel  wall  (irritation  from 
calculi,  impaction,  etc.)  favouring  the  entrance  of  the 
germ. 

At  any  rate,  whatever  may  be  the  real  explanation,  it 
is  simply  madness  for  anyone  to  imagine  that  any  such 
trivial  cause  as  cold,  over-fatigue,  etc.,  is  sufficient  per  se 
to  bring  on  an  attack.  As  Williams  rightly  enough  puts 
it,  '  It  is  very  true  that  impaction,  constipation,  intussus- 
ception, volvulus,  the  presence  of  calculi,  or  the  action  of 
irritant  poisons,  may  cause  great  congestion  and  inflam- 
mation of  the  intestinal  membranes ;  but  the  disease  to 
be  described  originates  siii  generis,  and  very  often  without 
the  occurrence  of  an  immediate  and  recognisable  cause 
of  direct  irritation.' 

Although  in  practice  we  are  somewhat  inclined  to 
hold  out  to  our  clients  the  possibility  of  a  case  of  '  colic  ' 
terminating  in  enteritis,  I  should  imagine  that  it  is  simply 
a  case  of  '  digging  a  large  enough  hole  to  clamber  out  of ' 
should  the  anim.al  unfortunately  die.  I  do  not  think  that 
any  one  of  us  honestly  believes  it  likely  to  happen  in  any 
great  number  of  cases.  We  are  far  more  likely  to 
inwardly  admit  that  the  case  we  have  misdiagnosed  as 
'  simple  colic '  is,  in  reality,  one  of  twist,  intussuscep- 
tion, etc. 

That  being  so,  and  taking  W^illiams'  statement,  'that 
the  disease  originates  stii  generis,'  to  mean  that  there  is 
some  specific  cause,  then  there  is  no  other  solution  that 
fairly  satisfies  the  problem  save  the  one  I  have  suggested 
— that  of  bacterial  infection. 


ENTERITIS 


205 


Symptoms. — Unfortunately,  these  are  too  well  known 
to  need  any  lengthy  description.  The  history  of  the  case 
invariably  points  to  the  attack  having  been  ushered  in 
with  rigors.  In  the  language  of  the  stable,  '  the  animal 
is  taken  with  a  shivering  fit.'  The  appetite  fails,  the 
breathing  becomes  quickened,  and  the  bowels  show  signs 
of  commencing  irritability  by  frequently  ridding  them- 
selves of  small  quantities  of  faeces. 

Following  this,  the  symptoms  of  abdominal  pain  com- 
mence, and,  gradually  increasing  in  intensity,  remain 
until  near  the  end  of  the  case.  All  indications  of  the 
most  severe  suffering  are  present.  The  animal  strikes 
at  the  belly  with  his  feet,  casts  anxious  and  dolorous 
looks  towards  the  flanks,  and  commences  alternately 
rolling  and  rising  to  his  feet,  and  sometimes  biting  madly 
at  his  sides.  The  pulse  is  increased  in  number,  hard, 
wiry,  and  quick,  up  to  120  beats  a  minute,  and  often 
scarcely  to  be  felt,  except  at  the  radial.  The  belly  is 
usually  normal  in  size — no  tympanites — and  appears 
more  or  less  tucked  up,  owing  to  the  contraction  of  the 
abdominal  muscles,  while  pressure  on  it,  in  some  cases, 
appears  to  cause  pain.  Profuse  perspirations  bathe  the 
body,  and  the  ears  and  legs  grow  deadly  cold. 

All  the  time  the  pain  has  been  continuous.  No 
moment's  remission  from  suffering  has  eased  the  agonized 
patient  and  relieved  the  veterinarian's  mind.  No  second 
of  quiet  has  occurred  to  break  the  dread  hurrying  forward 
of  the  fatal  symptoms.  The  animal  gradually  grows 
worse  and  worse,  and  every  symptom  here  mentioned 
appears  to  become  aggravated.  The  countenance 
becomes  pinched  and  haggard  in  the  extreme ;  the 
sweats  become  slowly  colder,  suggesting  to  the  touch 
the  nearness  of  dissolution,  and  causing  the  hand  to 
be   withdrawn    with    a    shudder ;    the    visible    mucous 


2o6  THE  COMMON  COLICS  OF  THE  HORSE 

membranes  are  an  intense  livid  red;  the  nostrils  are 
widely  dilated,  and  the  breath  coming  and  going  in  short, 
painful  sobs.  The  getting  up  and  down  has  resolved 
itself  into  a  ceaseless  circular  tramp  around  the  box  ; 
the  pulse  has  become  more  imperceptible  still,  but  yet 
maintains  its  speedy  beating,  and  the  belly  is  growing 
tympanitic. 

Later  still,  all  symptoms  of  pain  quickly  subside. 
The  bowels,  so  lately  the  seat  of  the  most  agonizing 
spasms,  have  become  gangrenous,  and  consequently  dead 
to  feelings  of  pain.  The  animal  then  stands  quiet,  and 
will  even  drink  and  endeavour  to  feed.  The  owner  is 
pleased,  and  anticipates  recovery.  Not  so  the  veteri- 
narian. He  knows  too  well  that  it  is  but  the  beginning 
of  the  end. 

The  haggard  expression  of  the  face  still  remains ;  the 
pulse  continues  thready  and  imperceptible ;  the  ex- 
tremities are  even  more  cold  than  before;  the  mouth  is 
cold,  clammy,  and  foetid,  and  the  body  is  shaking  with 
involuntary  tremors.  The  eyes  grow  amaurotic ;  the 
lips  hang  pendulous ;  the  legs  are  widely  propped  apart 
to  keep  the  staggering,  half-unconscious  brute  upon  his 
feet,  and  a  nervous,  anxious  whinny  greets  a  passing 
equine  friend. 

But  a  short  time  further  sees  the  end.  The  stagger 
gives  way  to  an  aimless  blunder  forward  ;  the  limbs 
collapse,  and  the  tortured  animal  sinks  to  expire  in  con- 
vulsions. What  was,  perchance,  but  six  short  hours 
before  a  handsome  specimen  of  the  equine  race,  with 
beauty,  health,  and  strength  depicted  in  each  line  of  his 
glossy,  well-kept  body,  now  Hes  a  dirt-besmeared,  worth- 
less carcass. 

Diagnosis. — Once  seen,  I  do  not  think  that  enteritis 
is    often    likely    to    be    misdiagnosed.       As    a    boy,    I 


ENTERITIS 


207 


remember  committing  to  memory  a  tabular  arrangement 
of  the  differentiating  features  of  enteritis  and  ordinary 
colic.  I  found  it  in  one  of  those  old-fashioned  works 
that,  in  one  volume,  deal  with  the  whole  'art  and  practice 
of  farriery,'  as  necessary  for  '  all  those  who  have  the 
government  of  cattle.'  Somewhat  too  precise  and  over- 
condensed  it  may  appear  to  modern  minds,  and  yet  it  is 
not  without  its  merits.     This  is  how  it  ran : 

Colic.  Inflammation  of  the  Bowels. 

1.  Sudden  in  its  attack.  i.  Gradual  in  its  approach,  with 

previous  indications  of  fever. 

2.  Intervals  of  rest.  2.  Constant  pain. 

3.  Pulse  only  becomes  frequent       3.  Pulse    continuously    frequent 

in  the  paroxysms  of  pain.  but  small,  and  often  scarcely 

In  intervals  of  ease  is  normal  to  be  felt, 

in  number  of  beats,  but  evi- 
dently fuller. 

4.  Legs  and  ears  of  the  natural      4.  Legs  and  ears  cold. 

temperature. 

5.  Relief  obtained  from  rubbing       5.  Belly  exceedingly  tender  and 

the  belly.  painful  to  the  touch. 

6.  Relief  obtained  from  motion.       6.  Motion  increasing  pain. 

7.  Strength  scarcely  affected.  7.  Rapid  and  great  prostration. 

Really  that  table  offers  the  major  points  to  be  con- 
sidered when  forming  an  opinion.  To  it  I  would  add 
that  the  circumstance  of  the  conjunctiva  being  so  highly 
injected,  and  the  fact  of  the  pulse,  temperature,  and 
respirations  all  three  immediately  participating  in  the  un- 
favourable indications,  are  all  manifestations  of  a  highly 
dangerous  condition. 

Almost  all  writers  appear  to  agree  in  stating  that  the 
belly  is  tender  to  the  touch.  Allowing  that  it  is,  it  is 
always  difficult  to  judge,  for  one  never  knov/s  how  much 
of  the  flinching  and  resentment  should  be  put  down  to 
restiveness. 


2o8  THE  COMMON  COLICS  OF  THE  HORSE 

After  all  is  said,  Percivall's  summing  up  remains  as 
good  now  as  on  the  day  on  which  it  was  written  :  '  The 
surest  diagnosis  between  colic  and  enteritis,'  he  says,  '  is 
to  be  found  in  the  history  of  the  case — in  particular,  in 
the  manner  of  the  attack,  in  the  intermissions,  in  the  state 
of  the  pulse,  and  in  the  progress  of  the  case.' 

Prognosis. — Once  certainly  diagnosed,  enteritis  offers 
but  little  hope  of  recovery.  It  is  so  commonly  fa>tal  as 
to  warrant  an  unfavourable  opinion  being  expr-essed  in 
every  case. 

In  ordinary  cases  of  colic,  as,  for  example,  impaction, 
irritation  by  calculi,  diarrhcea,  etc.,  there  is  no  doubt  that 
we  often  get  a  condition  that  properly  comes  under  the 
term  we  are  now  in  all  probability  misusing.  .  .  .  We 
get  a  limited  enteritis.  .  .  .  The  occasional  slight  rise 
of  temperature  in  these  cases  is  sufficient  to  point  that 
out.  Such  of  these  cases  as  yield  to  remedial  measures 
may  be  rightly  classed  as  recoveries  from  enteritis.  The 
name  '  enteritis,'  as  signifying  the  disease  I  have  been 
describing,  has  become  such  a  well-known  part  and 
parcel  of  veterinary  nomenclature  that  I  have  not  dared 
to  head  this  chapter  by  any  other  term.  Had  not  such 
been  the  case,  I  should  have  suggested  for  this  disorder 
some  such  appellation  as  '  intestinal  septic  infection,' 
'  intestinal  septicaemia '  —  in  short,  any  other  suitable 
name  that  would  have  left  the  word  *  enteritis  '  to  be 
properly  applied  to  those  conditions  it  more  fitly 
describes.  That  the  disorder  we  have  described  is  an 
enteritis,  or  inflammatory  condition  of  the  bowels,  I 
do  not  attempt  to  deny.  I  simply  maintain  that  its 
manifestations  are  so  peculiar  to  itself  as  to  point  to 
a  specific  cause  —  that  it  is  a  disease  by  itself — and 
ought,  therefore,  to  be  given  such  a  name  as  would 
definitely  distinguish  it  from  those  comparatively  minor 


ENTERITIS  209 

complaints  covered  by  such  an  all-embracing  term  as 
*  enteritis.' 

The  statement  with  which  I  have  headed  this  section 
would  then  need  qualification.  Recovery  from  the 
limited  enteritis  attending  other  and  less  dangerous  forms 
of  colic  is  not  only  possible,  but  a  matter  of  every-day 
occurrence. 

On  the  other  hand,  resolution  in  a  case  of  '  intestinal 
septicaemia,'  if  I  may,  for  a  moment,  be  allov/ed  to  so 
call  enteritis,  will  occur  with  about  the  same  frequency 
as  recoveries  from  the  intestinal  forms  of  anthrax. 
Knowing  that,  the  practitioner  will  appreciate  my 
statement,  '  enteritis  offers  but  little  hope  of  recovery,' 
at  its  true  value. 

Treatment. — I  must  confess  myself  to  looking  upon 
this  as  hopeless.  Once  established,  I  do  not  think  that 
enteritis — at  any  rate  the  enteritis  I  have  described — is 
in  the  slightest  degree  affected  by  anything  we  may  pour 
into  the  animal's  body.  Though  not  affecting  the  issue 
of  the  case,  humanity  points  to  a  manifest  duty.  It 
should  be  our  care  to  render,  if  possible,  any  aid  that  will 
mitigate  the  animal's  sufferings.  To  that  end,  the  most 
potent  anodynes  and  sedatives  should  be  employed. 
Even  should  we  succeed  in  inducing  a  state  of  delirious 
drunkenness,  that  is  manifestly  better  than  allowing  the 
patient  to  succumb  in  agonizing  tortures. 

Should  the  practitioner  deem  this  advice  too  dogmatic, 
and  conscientiously  feel  that  other  remedial  measures 
should  be  attempted,  he  will  find  plenty  to  his  hand  in 
other  and  well-known  volumes.  Personally,  I  do  not 
think  that  our  knowledge  of  the  etiology  of  this  disorder 
justifies  us  in  thrusting  upon  the  already  tortured  animal 
drugs  the  action  of  which,  in  this  particular  instance, 
must  be  highly  problematical.    This  is  one  case  in  which 

H 


410  IHE  COMMON  COLICS  OF  THE  HORSE 

we  may  safely  take  the  advice  of  a  cynic,  whose  name  I 
do  not  remember,  and  *  refrain  from  pouring  medicines 
of  which  we  know  little  into  a  body  of  which  we  know 
less.' 

Rather  should  the  attention  of  those  among  us  who 
have  a  natural  liking  for  investigation  be  strenuously 
devoted  to  searching  for  a  well-defined  and  certain  cause. 
We  may  then  be  better  directed  towards  devising  a  suit- 
able treatment.  All  this  indicates  most  strongly  that 
the  practitioner  of  veterinary  medicine  should  be  quite 
certain  of  his  diagnosis  before  he  commences  the  merciful 
administration  of  anodynes. 

In  spite  of  the  most  careful  reasoning,  and  in  spite  of 
the  most  painstaking  examination  and  observation,  cases 
of  colic  occasionally  crop  up  in  which  the  symptoms  are, 
for  a  time,  dangerously  alarming.  Enteritis  immediately 
suggests  itself  to  the  practitioner's  mind,  and  he  com- 
mences the  exhibition  of  sedatives.  Before  he  does  that, 
I  would  earnestly  advise  him  to  wait  until  his  somewhat 
tentative  opinion  has  become  an  absolute  conviction.  If  he 
has  not  the  courage  to  commence  a  stimulative  treatment 
at  the  outset,  at  any  rate  let  him  adopt  harmless 
expectant  measures.  Should  the  case  turn  out  to  be 
enteritis,  he  may  confidently  assure  himself  that  anything 
he  might  have  done  would  have  been  useless. 

On  the  other  hand,  should  the  alarming  symptoms 
begin  to  abate,  and  the  matter  resolve  itself  into  some 
more  simple  form  of  colic,  he  will  then  have  the 
advantage  of  being  able  to  push  stimulative  measures  on 
a  system  that  has  not  been  previously  placed  outside  the 
pale  of  hope  by  the  undue  administration  of  sedatives. 
He  will  find  the  average  of  his  cases  of  so-called  enteritis 
considerably  diminish  in  the  course  of  a  twelvemonth's 
reckoning,  and,  greater  boor,  still,  he  will  find  his  powers 


ENTERITIS  211 

of  diagnosis  in  colic  enormously  on  the  increase.     That, 
at  any  rate,  has  been  my  own  experience. 

To  my  mind,  it  is  largely  this  dread  of  enteritis,  and 
the  idea  the  practitioner  has  that  he  may  be  able  to  ward 
it  off  by  the  use  of  sedatives,  that  has  tended  to  paralyze 
any  forward  movement  towards  the  better  differentiation 
and  diagnosis  of  cases  of  veterinary  coHc. 


14—2 


CHAPTER  XVII 
SUPERPURGATION 

Definition. — That  form  of  colic  induced  by  the  in- 
ordinate action  of  a  purgative. 

Referring  to  Chapter  L,  and  consulting  Professor 
Friedberger's  table,  we  find  that  this  particular  form  of 
colic  would  come  under  the  heading  '  symptomatic,'  and 
that  further  classification  would  lead  us  to  the  fact  that 
it  is  colic  resulting  from  the  administration  of  a 
poison.  .  .  .  We  must  either  dub  aloes  '  a  poison,'  or 
inform  Professor  Friedberger  that  his  table  is  incomplete, 
and  that  he  has  made  no  mention  of  a  form  of  colic 
resulting  from  the  administration  of  a  harmless  drug. 
For  my  own  part,  so  far  as  the  horse  is  concerned,  I 
regard  aloes  as  a  poison.  The  astounding  fact  to  me  is 
that  it  has  not  been  so  called  before. 

WilHams,  in  his  '  Principles  and  Practice  of  Veterinary 
Medicine,'  devotes  a  chapter  to  the  consideration  of  this 
condition,  admitting  that  it  is  of  frequent  occurrence,  and 
yet  not  advising  the  more  restrained  use  of  aloes. 

Surely  it  is  an  astonishing  thing  that  a  drug  which  will 
commonly  give  rise  to  such  dangerous  symptoms  as  to 
call  for  a  separate  chapter  concerning  its  antidotes 
should  not  be  regarded  as  highly  dangerous.  Why  is  it 
that  other  drugs  have  not  elevated  other  conditions  to  a 


SUEERPURGATION  213 

position  of  the  same  fatal  prominence  ?  Why  is  it  that 
aloes,  above  all  other  drugs,  should  be  singled  out  in  this 
manner  ?     Simply  because  it  is  dangerous  ! 

If  a  new  drug  were  introduced  to-morrow,  with  only 
one-half  of  the  possibilities  of  danger  already  inherent  in 
aloes,  its  use  would  be  indignantly  scouted  by  more  than 
two-thirds  of  the  veterinary  profession.  And  yet,  I 
venture  to  say,  there  are  but  a  very  few  who  would  dare 
to  assail  aloes  in  the  same  manner. 

Regarding  the  medico-legal  questions  involved  in  its 
use,  Williams  says  : 

'  The  occurrence  of  superpurgation  after  the  ad- 
ministration of  a  simple  and  moderate  carthartic  by  the 
veterinarian  is  one  of  great  importance.  In  no  case 
where  due  caution  has  been  taken,  where  the  dose 
has  not  been  more  than  the  necessities  of  the  case 
required,  .  .  .  should  the  veterinarian  be  made  re- 
sponsible.' 

Personally,  I  should  consider  a  man  deserving  of  any 
trouble  that  might  accrue  therefrom  who  systematically 
uses  aloes  in  his  practice  without  urgent  calls  for  its 
administration.  Physicing  after  grass,  to  get  into  con- 
dition, to  remove  a  tendency  to  swelled  legs,  ...  all 
these  I  look  upon  as  foolish  and  useless  fads— practices 
which  the  intelligent  veterinarian  will  endeavour  to 
root  out  from  those  of  his  clients  who  are  amenable  to 
reason. 

Causes. — Although  giving  aloes  the  foremost  position 
among  the  causative  factors  of  this  dangerous  condition, 
it  must  not  be  forgotten  that  other  and  more  simple 
purgatives  will  bring  about  a  like  result  if  improperly 
administered,  or  if  due  care  is  not  afterwards  taken  of 
the  patient. 

In  a  case  of  pneumonia,  for  instance,  i  pint  of  some 


214  THE  COMMON  COLICS  OF  THE  HORSE 

simple  bland  oil — e.g.,  that  of  linseed — will  be  quite 
sufficient  to  cause  it.  Or,  again,  if  the  animal  is  put  to 
work  during  the  operation  of  even  a  simple  cathartic,  or 
is  exercised  too  soon  after  its  *  setting,'  the  same  dire 
results  are  likely  to  follow. 

This  only  shows  the  extreme  susceptibility  of  the  horse 
to  the  action  of  purgatives,  and,  if  anything,  serves  to 
still  further  discountenance  the  common  use  of  such  a 
drastic  purge  as  aloes. 

Symptoms. — Should  the  purgative  act  in  an  easy 
manner,  but  little  disturbance  of  the  system  will  be 
noticed.  The  pulse  becomes  a  little  weaker,  less  full, 
and  its  frequency  increased.  When  the  purging  is  about 
to  commence  the  coat  will  be  staring,  and  occasional 
tremors  present  themselves.  The  animal  at  this  stage 
is  nauseated,  appears  restless,  refuses  his  food,  and  shows 
a  slight  increase  in  the  number  of  respirations. 

Following  this  comes  the  increased  action  of  the 
bowels  and  the  evacuation  of  their  contents.  If  every- 
thing goes  well,  a  few  hours  will  see  a  gradual  return  to 
the  normal.  The  breathing  becomes  more  tranquil,  the 
pulse  grows  fuller  and  more  quiet,  and  the  appetite 
again  returns. 

Should  the  dose  h-ave  been  unsuited  to  the  patient, 
however,  or  should  some  adverse  circumstance  have 
been  in  operation,  the  symptoms  rapidly  grow  more 
alarming.  For  example,  if  there  has  been  any  previous 
slight  symptom  of  fever,  if  the  animal  is  allowed  to  drink 
large  quantities  of  cold  water,  or  if  he  be  exercised  or 
over-excited  in  any  way,  an  excessive  action  of  the  drug 
may  assuredly  be  expected. 

It  is  not  always,  however,  that  a  large  dose  of  aloes  is 
needed  to  bring  this  about.  It  is  not  always  that  any 
other    adverse    circumstance    need    be   in    simultaneous 


SUPERPURGATION  215 

Operation  to  bring  about  a  fatal  result.  It  is  in  these 
last  two  facts  that  the  danger  of  using  aloes  exists. 
Every  veterinary  surgeon,  I  might  say  without  excep- 
tion, is  aware  of  them,  and  he  still  persists  in  an  indis- 
criminate use  of  the  drug. 

Williams  himself  says :  '  Superpurgation  does  not 
always  depend  upon  the  strength  of  the  dose.  In  some 
instances  as  little  as  4  drachms  have  been  followed  by 
fatal  consequences.  Again,  horses  in  an  obese  con- 
dition .  .  .  are  easily  acted  upon  by  purgative  medicines, 
and  are  apt  to  sink  from  superpurgation.' 

Be  that  as  it  may,  whether  a  large  dose  is  necessary 
or  not,  or  whether  any  predisposing  circumstance  at  all 
is  needed,  it  still  remains  that  often  the  purge  does  not 
cease,  but  gives  rise  to  the  following  and  more  aggravated 
symptoms  : 

The  appetite  fails  to  return ;  the  discharge  becomes 
more  fluid,  more  frequent,  and  extremely  offensive,  and 
the  mucous  membranes  become  injected.  The  mouth 
is  dry,  furred,  and  foetid,  and  the  respirations  hurried. 
After  each  evacuation  the  animal  shows  evident  colic 
pains,  manifesting  them  by  crouching  movements,  and 
occasionally  lying  down.  Usually,  however,  he  stands 
quiet,  and  only  exhibits  his  pain  by  wandering  round  the 
box  or  pawing  with  one  foot  on  the  ground.  The  pulse 
has  become  thready,  weak,  and  quick,  and  prostration 
becomes  alarmingly  evident.  The  extremities  turn  cold, 
and  the  belly  appears  abnormally  tucked  up — in  some 
cases  tympanitic.  Everything  points  to  a  speedy 
collapse.  The  practitioner  is  only  too  painfully  aware  of 
the  danger  of  his  case,  and  understands  full  well  that  the 
most  prompt  and  energetic  measures  are  necessary  to 
combat  the  condition. 

Diagnosis.— The  history  of  the  case  and  the  evidence 


2i6  THE  COMMON  COLICS  OF  THE  HORSE 

of  one's  own  senses  leads  one  quickly  enough  to  the 
truth.     More  than  that  need  not  be  said. 

Prognosis. — To  a  great  extent  this  must  always  be 
guarded.  Even  should  the  pulse  and  other  symptoms 
point  to  nothing  really  alarming,  the  practitioner  must 
always  bear  in  mind  the  only  too  probable  sequels  of  this 
condition. 

Many  cases,  unfortunately,  end  with  some  such  serious 
trouble  as  pneumonia ;  others  in  a  long  and  severe 
attack  of  laminitis,  leaving  the  animal  a  useless  cripple. 

Taking  these  as  only  of  occasional  occurrence,  no  one 
will  attempt  to  deny  the  susceptibility  of  the  horse  to 
enteritis.  That  alone  should  lead  us  to  endeavour  to 
explain  to  the  owner  the  risk  the  animal  is  running,  and 
prepare  his  mind  for  the  probability  of  the  patient  rapidly 
sinking  under  an  exhaustive  inflammation  of  the  bowels. 

Treatment. — Called  in  at  the  commencement  of 
doubtful  symptoms,  the  best  and  most  simple  treatment 
is  a  dose  of  chloral. 

]^.  Chloral  hydratis §i. 

Aq.  fervens    -        -         -         -         -         .        -    ad  gx. 

Misce ;  fiat  haust. 
Sig. :  To  be  given  in  a  pint  of  thick,  cold  gruel. 

It  is  unusual,  however,  for  the  veterinary  surgeon  to 
be  summoned  early.  He  is  not  called  in  until  the 
symptoms  have  become  really  dangerous.  He  finds  his 
patient  with  quick  and  feeble  pulse,  abdomen  drawn  up, 
and  extremities  cold. 

Again  I  advise  the  administration  of  the  chloral,  this 
time  accompanied  with  a  hypodermic  injection  of  from 
3  to  5  grains  of  acetate  of  morphia.  This  will  tend  to 
allay  the  irritability  in  the  intestines,  and  induce  a  com- 
fortable sleep.  At  the  same  time  the  animal  should  be 
well  rugged  down  and  kept  perfectly  quiet. 


SUPERPURGATION  217 

If  the  flagging  system  appears  to  demand  it,  a  stiff 
dose  of  some  diffusible  stimulant  will  be  found  beneficial. 
Ten  to  fifteen  ounces  of  good  brandy,  or  a  suitable  dose 
of  spirits  of  nitrous  ether,  methylated  ether,  or  the 
aromatic  spirits  of  ammonia,  will  do  all  that  is  needed. 

The  combined  effects  of  the  purging  and  the  taking  of 
the  sedatives  will  sooner  or  later  cause  an  intense  desire 
for  drink.  Advantage  should  be  taken  of  the  animal's 
thirst  to  induce  him  to  swallow  small  quantities  of 
wheaten-flour  gruel  or  other  emolhent  drink.  This  I 
have  always  found  better  to  give  cold,  for  oftentimes  the 
drinking  of  only  a  few  mouthfuls  of  something  cool  and 
refreshing  will  tempt  the  animal  to  pick  a  little  solid  food 
— a  few  handfuls  of  hay  or  a  small  quantity  of  corn. 
This  will  go  far  to  bring  the  stomach  and  intestines  to 
their  normal  tone,  and  stay  the  purging. 

Some  practitioners  pin  their  faith  to  opium.  Unless 
the  case  is  one  of  great  urgency,  I  do  not  recommend  it. 
Following  its  administration  we  are  often  immediately 
jumped  from  the  extreme  of  violent  purging  to  the  height 
of  absolute  stasis  and  tympany.  It  is  hard  indeed  to  say 
which  is  the  worse  condition  of  the  two. 

In  conclusion,  I  feel  it  necessary  to  remind  the  reader 
that  this  chapter  has  not  pretended  to  treat  of  acute 
diarrhoea  arising  from  other  causes,  as,  e.g.,  the  ingestion 
of  irritating  or  fermenting  foods.  In  those  cases  the 
extreme  sedative  treatment  I  have  recommended  is  not 
to  be  advised.  The  action  of  the  bowels  should  not,  then, 
be  checked  too  rapidly.  Rather,  if  the  patient's  strength 
will  admit,  should  they  be  aided  in  ridding  themselves  of 
the  offending  materials. 

No  fixed  rules  for  the  treatment  of  ordinary  purging 
can  be  laid  down  with  any  safety — so  much  must  be 
left   to  the   good   sense    and  judgment    of  the    medical 


2t8  the  common  colics  of  the  horse 

attendant ;  so  much  will  depend  upon  the  history  of 
individual  cases,  and  the  patient's  idiosyncrasies.  As  old 
Francis  Clater  clearly  enough  puts  it,  '  Nothing  so 
much  distinguishes  the  man  of  good  sense  from  the  mere 
blunderer  as  the  treatment  of  purging.'  There  is  no 
reliable  '  rule  of  thumb  '  method  in  medicine.  Each 
case  must  be  treated  upon  its  own  merits. 


CHAPTER  XVIII 

THE  TREATMENT  OF  YOUNG,  UN- 
BROKEN ANIMALS 

What  I  am  about  to  write  of  now  may  more  concern 
the  student  and  beginner  than  the  staid  man  of  practice. 
Nevertheless,  I  did  not  feel  this  little  volume  to  be  com- 
plete without  some  mention  of  the  matter  now  under 
consideration. 

Yearlings  arid  Two-year-olds- — There  is  nothing  so 
difficult,  even  to  the  practised  veterinarian,  as  the  correct 
diagnosis  of  'colic'  in  an  unbroken  colt.  In  many 
instances  the  animal  is,  perhaps,  at  pasture.  He  is  seen 
to  be  lying  or  rolling  about,  and  is  driven  up  into  the 
yard  for  treatment.  If  he  is  fortunate  enough  to  have 
received  no  pulling  about  or  forcing  of  medicines  upon 
him  by  the  owner,  the  patient  will  give  a  tolerably  clear 
account  of  his  trouble  to  the  skilled  attendant.  More 
often  than  not,  however,  he  will  have  been  haltered  and 
twitched,  and  some  patent  *  cure-all '  thrust  upon  him. 
In  that  case  the  excitement  of  his  new  surroundings,  and 
the  exertion  of  fighting  against  restraint,  will  have  led  to 
a  perplexing  set  of  symptoms.  He  is,  perchance,  in  a 
bath  of  sweat,  his  conjunctiva  injected,  his  respirations 
enormously  hurried,  and  his  pulse  beating  at  a  frantic 
rate.       All   this   may    be  due   to   the    treatment  he   has 


220  THE  COMMON  COLICS  OF  THE  HORSE 

received,  and  may  not  always  be  taken  as  evidence  of 
pain.  Prognosis — nay,  even  diagnosis  —  should  be 
extremely  guarded  in  such  a  case. 

If,  on  the  other  hand,  the  animal  has  been  allowed  to 
remain  without  interference  in  the  place  in  which  he  was 
taken  ill,  the  veterinary  surgeon  will  start  with  a  *  clean 
slate.'  That  will  give  him  great  facilities  he  should  not 
fail  to  take  advantage  of.  On  no  account  should  the 
animal  be  immediately  haltered  and  handled,  for  most 
certainly  that  will  effectually  mask  what  symptoms  he 
may  be  presenting.  He  should  be  quietly  watched,  and 
the  few  signs  he  shows  carefully  estimated.  The  in- 
formation likely  to  be  derived  from  this  preliminary 
observation  I  have  already  detailed  in  the  chapter  '  How 
to  Examine  the  Patient.'  Even  then  the  veterinary 
surgeon  must  take  into  consideration  the  class  of  horse, 
and  probable  temperament,  with  which  he  is  dealing.  In 
a  high-bred,  nervous  animal,  the  unusual  position  in 
which  he  finds  himself  (that  of  unknown,  and  to  him  un- 
accountable, pain)  and  his  natural  timidity  make  him  in 
many  instances  altogether  hide  his  distress.  He  may  be 
suffering  untold  agonies.  Yet  he  stands  quiet,  and  only 
reveals  the  intensity  of  his  torment  by  such  signs  as  may 
be  noticed  by  this  introductory  '  look  round.' 

Our  next  patient,  with  nothing  really  serious  ailing 
him,  may  roll  and  smash  about  to  an  alarming  degree, 
is  more  subdued  when  caught  and  handled,  and  lends 
himself  well  to  manipulative  examination. 

These  are  the  two  extremes.  There  are  all  gradations 
between  the  two,  and  the  veterinary  surgeon  must  in 
each  instance  judge  the  case  from  its  own  standpoint. 
Care  should  be  taken  to  notice  the  way  in  which  the 
patient  takes  a  drench.  If  he  is  at  all  restive  and  in- 
clined to  fight  against  it,  it  should  be  withheld,  and  the 


THE  TREATMENT  OF  YOUNG,  UNBROKEN  ANIMALS   221 

after-treatment  carried  on  by  means  of  balls,  hypodermic 
injections,  and  suitable  enemas.  If  this  precaution  is  not 
taken,  and  forcible  drenching  is  persisted  in,  the  veterinary 
surgeon  will  have  a  much  worse  case  on  his  hands  in  the 
shape  of  a  severe  attack  of  pneumonia,  caused  by  the 
aspirating  of  the  liquid. 

To  the  beginner,  with  his  first  case  of '  colic '  in  an  un- 
broken colt,  I  would  advise  this  :  '  Put  your  case  down 
half  as  bad  again  as  your  diagnosis  has  led  you  to 
imagine,  and  you  will  be  nearer  by  far  to  the  truth  of  the 
animal's  condition.' 

Foals. — In  these  days  of  extensive  breeding  of  high- 
class  stock,  with  the  increase  in  value  of  their  progeny, 
the  foal  will  demand  a  large  share  of  our  attention. 
Those  resident  in  or  near  a  large  breeding  centre  know 
full  well  the  many  annoyances  and  disappointments  met 
with  in  treating  these  delicate  animals.  The  veterinary 
surgeon's  position  is  rendered  the  more  difficult  in  that 
every  foal,  when  he  is  dropped,  is  looked  upon  with 
loving  eyes  and  watched  with  careful  tenderness,  as  a 
probable  future  money-mill  in  the  shape  of  a  successful 
stallion,  or  the  winner  of  substantial  money  prizes  at 
the  agricultural  shows. 

There  is  not  one  in  fifty  that  fulfils  the  hopes  so 
centred  on  him  by  his  owner,  and,  when  he  becomes  a 
raw  and  ugly  yearling,  or  a  comparatively  worthless  two- 
year-old,  the  veterinary  surgeon  may  treat  him  without 
anxiety.  Still,  as  a  foal  he  is  an  unworked  gold-mine. 
He  is  regarded  as  such  by  his  owner,  and,  as  a  conse- 
quence, his  case  must  be  treated  with  every  solicitude  by 
the  veterinarian. 

Paradoxical  though  it  may  appear,  the  treatment  of 
'colic'  pains  in  foals  is  both  simple  and  difficult.  It  is 
simple  in  that  the  best  remedies  are  those  usually  affected 


222  THE  COMMON  COLICS  OF  THE  HORSE 

by  the  owners  themselves — the  cases  partaking  more  of 
the  nature  of  a  baby  and  its  nurse  than  of  the  adult  patient 
and  his  medical  man.  They  are  difficult  in  that  our  powers 
of  diagnosis  concerning  them  are  as  yet  but  limited. 

Diavvhcea. — Probably  the  most  common  form  of  colic 
in  the  very  young  foal  is  that  occasioned  by  diarrhoea — • 
'  scouring,'  as  it  is  commonly  termed.  If  the  case  has 
not  been  long  about,  and  the  young  animal  is  fairly 
strong,  by  far  and  away  the  best  initial  treatment  is  a 
suitable  dose  of  castor-oil.  This  is  best  given  in  the 
form  of  an  emulsion.  The  following  is  a  good  mixture 
for  the  purpose  : 

J^i.    Ol.  ricini      .......  gi. 

Liq.  potassse         -..-..  tnxxx. 

Ol.  menth,  pip.    ---.--  niv. 

Aquam ad  5ii- 

Misce  ;  fiat  haust. 

If  the  foal  is  but  a  week  or  so  old  the  above  quantity 
will  be  found  sufficient.  If  at  all  older  and  not  weakly, 
double  the  quantity  may  safely  be  given.  In  many 
cases,  where  the  symptoms  appear  to  demand  it,  a  suit- 
able stimulant  may  be  added  in  the  shape  of  spts. 
ammon.  ar.,  spts.  eth.  nit.,  or  a  small  dose  of  brandy. 
Very  often,  after  the  lapse  of  only  a  few  hours,  this  dose 
of  castor-oil  will  have  stayed  the  purge.  Should  it  have 
failed,  it  will  then  be  necessary  to  follow  it  up  by  the 
administration  of  combined  astringents,  antacids,  and 
sedatives.  The  following  is  a  very  old-fashioned  recipe, 
and  yet  one  of  the  most  suitable  : 

J^i.  Catechu  pulv.        -         -        .        -        -     \__  ^... 

Cretae  preparatae |^^  5^"' 

Spt.  ammon,  ar.    -----         -      gii. 

Tinct.  opii      -         - §i. 

Aquam -        -      ad  5xii. 

Misce ;  fiat  mist. 


THE  TREATMENT  OF  YOUNG,  UNBROKEN  ANIMALS  223 

This  may  be  given  in  i  or  2  ounce  doses  as  the  case 
demands,  mixed  with  a  Httle  of  the  mare's  milk. 
Following  the  administration  of  the  sedatives,  careful  as 
we  may  be  with  the  dose,  it  often  happens  that  we  have 
to  face  a  case  of  intestinal  stasis.  This  must  be  carefully 
treated  by  means  of  the  castor-oil  emulsion,  this  time 
combined  with  a  small  quantity  (say,  Hl^xxx.  to  3i.)  of 
tinct.  nucis  vom.  Perhaps  a  rather  more  suitable  line  of 
treatment,  however,  is  to  combine  the  castor-oil  with 
glycerine,  thus : 

R.  01.  ricini §i. 

Glycerini      --.--.-  gss. 

01.  menth.  pip. tnx. 

Aquam-         .-__.,.  ad  3ii. 
Misce ;  fiat  haust. 

These  cases  of  scour  are  often  very  troublesome,  and 
much  will  depend  upon  the  good  judgment  and  careful 
attention  of  the  nurse — not  the  veterinarian.  The  foal 
should  not  be  dosed  standing,  but  thrown  on  its  side. 

When  attending  a  case  of  colic  in  a  very  young  foal  in 
which  there  is  no  definite  sign  or  history  of  scour,  the 
veterinarian  must  be  extremely  careful.  There  are  at 
least  two  conditions  which  may  seriously  mislead  him 
in  his  diagnosis — viz.,  accidental  hriiising  of  the  intestine  and 
scrotal  hernia. 

Injured  Intestines. — This,  I  think,  is  far  more  common 
than  is  generally  supposed,  and  is  probably  accountable 
for  many  of  the  deaths  ascribed  to  '  colic'  It  is 
occasioned  by  the  mare  treading  on  the  abdomen  of  the 
young  animal  when  it  is  stretched  at  sleep.  I  have  seen 
more  than  one  case  of  the  sort  where  the  cause  has 
clearly  been  traced,  and  it  leads  me  to  think  that  often  it 
may  occur  and  not  be  noticed.     After  the  infliction  of  the 


224  27/ii  COMMON  COLICS  OF  THE  HORSE 

injury  the  foal  is  soon  taken  ill.  The  pains  are  slight 
but  constant,  and  the  young  animal  is  nearly  all  the 
time  down.  If  there  is  no  history  of  the  hurt,  a  mistaken 
diagnosis  is  really  quite  excusable,  for  these  small 
creatures  show  no  symptoms  definite  enough  to  lead  to 
the  truth.  When  present,  however,  one  symptom  is 
almost,  if  not  quite,  diagnostic — blood-stained  faeces.  It 
is  not  that  dark,  coffee- coloured  stain  so  often  found 
coating  the  dung-balls  of  an  adult  animal  in  a  case  of 
obstinate  impaction,  but  distinct  strings  of  coagulated 
blood  mixed  with  the  excreta. 

When  diagnosed,  little  can  be  done  save  warn  the 
owner  of  the  indefinite  state  of  our  knowledge  (we  have 
no  means  of  ascertaining  whether  or  no  the  intestine  is 
actually  niphired),  and  then  to  rest  the  animal  and  the 
bowels  as  much  as  possible  by  the  use  of  sedatives.  As 
it  may  be  necessary  to  continue  the  sedatives  for  a  day 
or  two,  it  will  be  found  advisable  to  resort  to  a  com- 
bination of  several,  and  not  maintain  the  administration 
of  one  drug.  Chlorodyne  will  be  found  a  very  good 
agent.  Even  this,  however,  may  be  objected  to  on  the 
ground  that  it  contains  such  a  stimulant  as  tinct.  capsici. 
Perhaps  the  safest  way  is  to  give  alternate  doses  of  tinct. 
opii,  chloral  hydras,  and  ext.  cannabis  indicae.  As  far 
as  is  deemed  wise,  the  foal's  diet  should  be  restricted  by 
milking  the  mare. 

As  the  foal  grows  older  he  is  not  so  likely  to  allow 
himself  to  get  trodden  on  in  this  manner,  and  yet  may 
sustain  a  similar  injury  in  a  different  way,  e.g.  : 

One  case  has  come  under  my  notice  where  the  animal, 
when  allowed  to  run  out  for  the  first  time  or  two,  has 
slipped  up  violently  on  to  his  side  during  his  first  pre- 
liminary gambol.  This  again  has  produced  enteritis  and 
led  to  fatal  results.     Colic  pains  always  accompany  the 


THE  TREA  TMENT  OF  YO  UNG ,  UNBROKEN  A  NIMA  LS     225 

injury,  and  nothing  but  a  careful  inquiry  into  the  history 
will  serve  to  distinguish  them  from  pains  proceeding  from 
a  more  simple  cause. 

Intestinal  Impaction. — Later  in  the  season,  as  the 
foals  grow  older,  and  begin  to  nibble  for  themselves, 
uncomplicated  cases  of  subacute  intestinal  obstruction 
will  be  met  with,  occasioned  by  impaction  with  im- 
properly digested  food.  A  fairly  frequent  cause  of  this 
impaction  in  foals  is  the  peculiarly  dirty  habit  these 
animals  appear  to  have,  when  first  they  begin  to  pick  for 
themselves,  of  nibbling  at  mounds  of  decaying  litter, 
dried  or  rotting  vegetation,  or  even  the  mare's  excreta. 
This  should  always  be  kept  in  mind,  and  care  taken  to 
prevent  it  where  likely  to  occur. 

It  is  now  that  sedatives  may  be  dismissed  from  the 
veterinarian's  mind,  for  his  case  will  progress  better 
under  a  stimulative  treatment.  The  animal  has  attained 
a  reasonable  size,  and  his  strength  will  readily  allow  of 
more  active  measures  being  persisted  in.  With  due 
allowance  for  the  dose,  he  may  now  be  treated  exactly  as 
the  adult — viz.,  by  means  of  oleaginous  purgatives,  nux 
vomica,  and  stimulants.  No  matter  what  the  diagnosis, 
an  enema  should  always  be  given  for  the  purpose  of 
ascertaining  the  state  of  the  rectal  contents.  It  is,  of 
course,  impossible  to  insert  the  whole  of  the  hand,  and  it 
is  doubtful  whether  digital  exploration  gives  information 
enough. 

The  necessity  for  always  using  the  enema  syringe  was 
forcibly  driven  home  to  me  some  years  ago  when  treating 
a  four-months-old  foal.  He  was  showing  ordinary  dull 
pains.  I  administered  the  usual  medicines,  and,  more  to 
please  the  owner  than  with  the  idea  of  doing  good,  pro- 
ceeded to  give  an  enema.  The  rectum  was  in  a  state  of 
great  impaction.     With  the  injection  of  each  syringeful 

15 


226  THE  COMMON  COLICS  OF  THE  HORSE 

of  water  there  came  away  a  most  abnormal  quantity 
(for  so  small  an  animal)  of  hard  pellets  of  faeces.  What 
was  more  to  the  point,  instant  relief  was  thereby  afforded. 
What  would  have  occurred  had  sedatives  been  given  to 
ease  the  pains,  and  the  rectum  left  unexplored,  because 
the  animal  was  so  small  ? 

Strangulated  Hernia. — Lastly,  one  word  of  caution 
to  the  beginner.  When  called  to  a  case  of  colic  in  a 
young  colt  foal,  always  lay  him  down,  have  the  top 
hind  limb  drawn  back,  and  examine  the  contents  of  his 
scrotum.  If  suffering  from  hernia,  it  happens  some- 
times that  the  portion  of  bowel  in  the  scrotum  becomes 
impacted.  It  is  thus  unable  to  pass  its  contents  along, 
and  finally  becomes  strangulated.  When  present,  the 
rupture  should  be  carefully  manipulated  in  order  to  judge 
of  the  state  of  its  contents.  Should  any  doubt  exist, 
everything  in  the  scrotum  should  be  gently  pressed  back 
into  the  abdominal  cavity. 

These  few  scattered  remarks  on  this  last  subject  do 
not  pretend  to  be  even  an  epitome  of  the  treatment  to  be 
adopted.  They  simply  offer  a  groundwork  on  which  the 
veterinarian  must  build  up  his  own  methods  of  practice. 
The  subject  is  yet  too  indefinite  to  lay  down  any  dog- 
matic rules  upon,  and  much  may  be  done  by  future 
writers  in  contributing  to  this  branch  of  our  literature. 

With  this  my  small  work  on  '  Colic  '  is  finished.  I  do 
not  claim  that  it  is  exhaustive,  but  I  do  hope  that  I  have 
been  successful  in  placing  some  matters  in  such  a  light 
as  to  lead  to  newer  lines  of  thought  and  fuller  investiga- 
tion. 

If  we  are  ever  to  better  our  means  of  diagnosis  in  these 
troublesome  and  vexatious  complaints,  and  lead  the  way 
to  a  fuller  understanding  of  the  more  fearsome-sounding 
conditions  among  them,  it  will  only  be  by  commencing 


THE  TREATMENT  OF  YOUNG,  UNBROKEN  ANIMALS     227 

at  the  very  beginning.  Those  cases  which  are  of 
practically  every-day  occurrence,  and  which  thereby 
come  to  be  treated  by  somewhat  '  rule  of  thumb ' 
methods,  should  be  the  first  to  receive  our  attention.  A 
fuller  knowledge  of  their  peculiarities  would,  perhaps, 
prove  the  stepping-stone  to  something  greater. 

Do  not,  immediately  a  horse  begins  to  roll,  call  it 
*  spasm,'  and  forthwith  administer  an  antispasmodic,  or 
call  it  '  pain,'  and  cover  it  up  with  a  sedative.  Some- 
thing more  than  that  is  required  of  the  modern  veterinary 
surgeon,  if  he  is  to  enhance  the  reputation  of  his  pro- 
fession. Nothing  should  be  thought  too  small,  nothing 
deemed  too  insignificant,  to  aid  him  in  his  endeavour  for 
honest  advance.  No  amount  of  theoretical  knowledge 
should  cause  the  practitioner  (especially  the  veterinary 
practitioner)  to  neglect  the  *  apparently  trivial '  —  the 
habit  of  clinical  observation.  Even  as  in  the  time  of 
Percivall,  the  greatest  possible  facilities  for  the  further- 
ance of  our  education  are  to  be  found  in  the  sick-box. 
There  is  still  room  for  careful  research,  still  the  need  for 
much  patient  recording  of  cases,  and  still  a  large  amount 
of  useful  knowledge  to  be  acquired  concerning  the 
Common  Colics  of  the  Horse. 


15- 


per  cent. 


APPENDIX^ 

I.  The  Composition  of  Various  Foods :  Digestive 
Coefficients  of  Foods 

The   composition  of  various  foods,  as  judged  by  their 
analyses,  is  usually  given  in  the  following  terms : 

Moisture         _         -         .         - 

Fat 

Nitrogenous  substances 

Carbohydrates  (soluble) 

Fibre 

Ash        ----- 

A  brief  description  of  the  above  may  be  of  some  use  : 

Moisture  refers,  of  course,  to  the  water  which  may 
be  volatilized  at  a  temperature  of  ioo°  C.  (212°  F.). 

Fat  includes  the  solid  and  liquid  glycerides  of  fatty 
acids,  composed  of  carbon,  hydrogen,  and  a  little  oxygen. 
Fats  are  soluble  in  ether. 

Nitrogenous  Substances  is  a  broad  term,  used  to 
indicate  (usually)  all  the  compounds  of  a  food  which 
contain  nitrogen.  Under  this  heading  are  included  the 
albuminoids  or  proteids  which  have  a  high  feeding  value, 
and  also  frequently  the  amides,  which  have  only  slight 
nutritive  properties.  They  are  composed  of  carbon, 
hydrogen,  oxygen,  nitrogen,  and  sulphur,  and  contain 
about  6'25  per  cent,  of  nitrogen. 

Carbohydrates  (Soluble). — Under  this  heading  all 

^  For  Part  I.  of  this  appendix  I  am  indebted  to  my  friend  Mr. 
E.  Wightman  Bell,  F.C.S.,  District  Agricultural  Analyst  for  the 
Holland  Division  of  Lincolnshire. — H.  C.  R. 


APPENDIX 


229 


those  compounds  of  carbon,  hydrogen,  and  oxygen  which 
are  soluble  in  dilute  acids  and  alkalies  are  included,  such 
as  sugar,  starch,  mucilage,  pectin,  etc. 

Fibre. — The  remaining  organic  constituents  which 
are  not  soluble  in  the  diluted  acids  or  alkalies  used  by 
the  analyst  are  classed  as  fibre.  The  whole  of  this  fibre 
is  not  indigestible,  but  the  amount  capable  of  digestion 
is  very  variable,  and  fibre  is  consequently  usually  classed 
as  of  no  feeding  value. 

Ash. — This  is  the  mineral  or  incombustible  part  of 
food,  composed  of  inorganic  salts,  a  portion  of  which 
is  used  for  the  formation  of  bone,  etc. ;  but  by  far  the 
greater  portion  is  passed  out  in  the  excreta. 

Nitrogenous  substances  are  frequently  called  '  flesh- 
formers,'  whilst  fat  and  carbohydrates  are  designated 
'  fat  or  heat  formers.' 

Chemical  Composition  of  Certain  Foods. — From 
analyses  made  .by  the  writer  and  other  analysts,  the 
following  table  shows  the 

Average  Composition  of  Certain  Foods. 


Nitro- 

Carbo- 

Moisture. 

Fat. 

genous 
Substances. 

hydrates 
(soluble). 

Fibre. 

Ash. 

♦Wheat 

15-56 

1-63 

11-47 

67-55 

216 

1-63 

*Barley 

18-23 

1-90 

1050 

64-10 

3-24 

2-03 

*Oats     - 

I57I 

4-81 

13-13 

55-45 

8-00 

290 

Maize  - 

II-I2 

5-20 

10  40 

6935 

2-32 

I -61 

*Peas    - 

16-45 

1-83 

23-62 

50-00 

5-04 

3-06 

♦Beans  - 

16-25 

1-66 

26-25 

47-36 

5-7^ 

277 

♦Potatoes       - 

75-90 

0-I5 

2-eo 

19-56 

112 

0-67 

♦Mangels 

89-35 

0'22 

1-32 

6-95 

0-91 

1-25 

Carrots 

87-21 

0-20 

I -20 

8-99 

1-45 

0-95 

Meadow  hay 

13-20 

2-6i 

8 -60 

42-99 

26-75 

5-85 

Clover  hay 

15-67 

2-90 

11-85 

39-56 

25-40 

4-62 

Bran    - 

14-50 

3-i8 

13-68 

53-25 

9-21 

6-18 

Straw  (cereal) 

14-19 

1-53 

3-35 

36-60 

40-00 

4-33 

*  Analyses  by  the  writer. 


230  THE  COMMON  COLICS  OF  THE  HORSE 

In  comparing  the  feeding  value  of  different  foods 
(apart  from  their  '  balance  'i),  it  is  useful  to  calculate  the 
food  units  which  are  contained  in  them.  In  calculating 
the  food  units,  it  is  assumed  that  the  moisture,  fibre,  and 
ash  are  of  no  feeding  value.  Experiments  have  shown 
that  fats  and  albuminoids  produce  (practically)  two  and 
a  half  times  the  heat  that  carbohydrates  do ;  therefore, 
to  obtain  the  food  units,  .we  add  the  percentages  of  fat 
and  nitrogenous  substances,  multiply  the  sum  by  2J,  and 
add  the  percentage  of  carbohydrates.  The  result  is  the 
number  of  food  units. 

As  an  example,  let  us  calculate  the  food  units  of  oats  and 
beans  from  the  composition  given  in  the  previous  table  : 

Oats.  Beans. 

Fat  .  -  -  .  4-81  166 

Nitrogenous  substances  -       13' 13  26-25 

27-91 
Multiply  by    -        -        -  2|  2| 


1794 

2i 

44-85 
55-45 

69-77 

Add  carbohydrates  -      55-45  47  36 

Food  units       -         -        -     100-30  117*13 

It  will  thus  be  seen  that,  if  all  were  digested,  the 
feeding  value  of  oats  and  beans  is  in  the  ratio  of 
oats  100  and  beans  117 — that  is  to  say,  beans  have 
about  one  sixth  more  feeding  value  than  oats  ;  or, 
6  pounds  of  beans  will  produce  as  much  heat  and  energy 
as  7  pounds  of  oats. 

As  these  calculations  of  food  units  are  taken  on  the 
composition  of  the  food,  it  follows  that  the  whole  of  the 
constituents  are  included,  whether  digested  or  passed 
out  as  manure,  their  use  both  as  foods  and  fertiUzers 
being  taken  into  account,  for,  with  ordinary  care,  what 
is  not  used  as  food  is  utilized  as  manure. 

Digestive  Coefficients  of  Foods. — The  composition 

^  I.e.,  the  ratio  of  nitrogenous  to  non-nitrogenous  foods. 


APPENDIX 


231 


of  a  food  as  ascertained  by  chemical  analysis  is  of  great 
value  in  the  comparison  of  foods,  and  especially  of  foods 
of  the  same  class.  It  must  not,  however,  be  assumed  that 
an  animal  is  capable  of  digesting  the  whole,  or,  in  many 
cases,  anything  approaching  the  whole,  of  the  nutritive 
constituents. 

The  amount  digested  varies  (i)  with  the  kind  and 
age  of  the  animal ;  (2)  with  the  class  of  food.  Ruminants 
naturally  digest  more  of  the  so-called  indigestible  fibre 
than  horses,  so  that  such  foods  as  grass  or  hay  are  of 
greater  feeding  value  for  sheep  and  oxen  than  for  horses. 
In  the  case  of  cereals  and  the  leguminous  foods,  the 
power  of  digestion  of  both  classes  of  animals  is  very 
similar.  The  following  table,  drawn  up  from  various 
sources  (especial  use  having  been  made  of  the  investiga- 
tions of  Dr.  E.  Wolff),  shows  the 

Average  Percentage    of  Digestible   Constituents 
IN   FooDs.i 


Albuminous 
Compounds. 

Carbohydrates. 

Fat. 

Wheat      - 

II'O 

64-0 

I-O 

Barley      - 

7 '5 

57 '5 

1-5 

Oats 

8-0 

45"o 

4-0 

Maize      - 

8-0 

68-5 

40 

Peas 

20 'O 

52-0 

Id 

Beans 

22 -o 

50-0 

I  5 

Potatoes  - 

2-0 

20  "O 

Mangels  - 

i-o 

yo 

— 

Carrots    - 

0-5 

7-0 

— 

Meadow  hay    - 

5-5 

40-0 

I'O 

Clover  hay 

6-5 

35 -o 

15 

Bran 

10-5 

44*5 

2-5 

Straw  (cereal) 

1*5 

40*0 

I-o 

Linseed  cake   - 

25-0 

300 

9 '5 

Locust  meal     - 

2-5 

72*0 

i-o 

^  In  the  above  table  the  figures  are  only  carried  to  the  nearest 
\  per  cent.     It  may  be  noted   that  in  some  cases  the  amount  of 


232  THE  COMMON  COLICS  OF  THE  HORSE 

It  has  been  ascertained  that  the  best  balanced  diet  for 
the  horse  is  one  which  has  an  albuminoid  ratio  of  about 
I  to  8.^  That  is  to  say,  the  amount  of  albuminous  com- 
pounds should  be  about  one-eighth  of  the  carbohydrates 
and  fat,  the  latter  having  been  multiplied  by  2J,  as  stated 
under  food  units. 

As  an  example,  let  us  calculate  the  albuminoid  ratio 
of  oats.  Referring  to  table  of  digestible  composition 
(p.  213),  we  find  oats  contain  : 

Fat,  4  per  cent. ;  carbohydrates,  45  per  cent. ;  and 

albuminoids,  8  per  cent. 
4  X  2|  +  45  =  55,  which,  divided  by  8  (albuminoids), 

—  6*9  (nearly).      The  albuminoid  ratio  of  oats  is 

therefore  very  nearly  i  to  7. 

Experiments  have  further  shown  that  a  horse  of 
1,000  pounds  weight,  when  at  rest,  requires  8  pounds 
of  dry  digestible  food  constituents  to  maintain  it.  The 
amount  necessary  is,  of  course,  considerably  increased 
when  a  horse  is  at  work,  and  as  the  average  cart-horse 
will  weigh  over  1,000  pounds,  we  may  put  the  average 
requirement  as : 

When  at  rest,  10  to  12  pounds  digestible  constituents. 
When  moderately  worked,  16  to  18  pounds  digestible 

constituents. 
When    heavily   worked,  22    to    24   pounds   digestible 

constituents. 

Having  an  albuminoid  ratio  of  i  to  8. 

How  seldom  is  the  diet  varied  according  to  the  amount 

carbohydrates  is  in  excess  of  that  given  in  the  first  table  ;  this 
is  due  to  digestible  fibre  being  added  to  the  carbohydrates  in  this 
table. 

^  This  is  about  the  ratio  given  by  good  quality  hay. 


APPENDIX 


233 


of  work  to  be  performed !    A  common  daily  feed  for  cart- 
horses in  South  Lincolnshire  is  in  winter  composed  of : 

Corn!        -         -     14  pounds. 
Cut  straw  -     20        ,, 

Mangels  -         -     21        ,, 

What  digestible  matter  is  furnished  by  a  diet  of  this 
description  ?  To  calculate  this  (and  as  it  is  of  frequent 
use  it  may  be  as  well  to  state  it  fully)  we  refer  to  the 
table  of  digestible  constituents  (p.  231),  and,  taking  each 
constituent  separately,  multiply  the  percentage  by  the 
number  of  pounds  of  food  taken,  move  the  decimal  point 
two  places  to  the  left  {i.e.,  divide  by  100),  which  will  give 
the  number  of  pounds  of  that  particular  constituent  in 
the  weight  of  food  given. 

For  instance,  how  much  digestible  albuminous  matter 
is  contained  in  7  pounds  of  maize  ? 

8-0x7  =  56'o  -r  100  =  0*56  pound. 

Working  in  this  way,  we  find  that  the  diet  named 
above  has  the  following  feeding  value  : 


7  pounds  maize    - 
7  pounds  bran 

20  pounds  straw     - 

21  pounds  mangels 


Albuminous 
Compounds. 


0-56 

073 
0-30 
0'2I 

I -So 


Carbohydrates. 


479 

3-12 

8'oo 
1-47 

0-28 
0-17 

0-20 

1-80 


17-38 


Plus  carbo- 
hydrates 


Fat. 


0-65 

X2i 

1-62 

17-38 

19*00 


1  This  is  a  mixture  of  indefinite  composition,  often  consisting  of 
equal  quantities  of  bran  and  maize. 


234 


THE  COMMON  COLICS  OF  THE  HORSE 


This  diet,  therefore,  gives  a  total  digestible  feed  of 
20*8  pounds,  having  an  albuminoid  ratio  of  about  i  to 
10*5.  An  average-sized  cart-horse,  doing  a  fair  day's 
work,  is  therefore  receiving  about  the  correct  quantity 
of  total  food  ;  but  the  balance  is  not  good,  the  albuminoids 
being  insufficient. 

An  approximately  correct  diet  may  be  compounded  as 
follows : 


Albuminous 
Compounds. 

Carbohydrates.              Fat. 

1 

3  pounds  beans    -         : 

4  pounds  maize    - 
7  pounds  bran 

20  pounds  straw     - 

21  pounds  mangels 

066 
0-32 

073 
0-30 
0-21 

1-50 
274 
3-12 

8-00 
1-47 

0-04 
016 
0-17 

0-20 

2-22 

16-83 

Plus  carbo- 
hydrates 

0-57 

X2i 

I -42        1 

1683 

2*22 

18-25 

This  gives  2o|  pounds  digestible  food,  with  an  albu- 
minoid ratio  of  about  i  to  8-2.  It  is,  therefore,  nearly 
theoretically  correct,  and,  being  of  a  compound  character 
as  regards  class  of  foods,  would  be  an  excellent  diet. 

It  should,  however,  be  noted  that  these  rations  should 
be  very  considerably  reduced  on  non-working  days,  as 
they  are  under  those  circumstances  very  wasteful,  being 
much  in  excess  of  the  requirements  of  the  animal,  and 
thus  giving  the  horse  more  work  to  do  to  digest  it. 

In  conclusion,  it  may  be  pointed  out  that  it  is  a  very 
simple  matter  to  arrange  a  diet  from  the  tables  given  to 
suit  any  particular  case,  all  that  is  necessary  being  to  work 


APPENDIX  535 

out  from  the  table  the  composition  of  the  food  suggested 
to  be  given,  and  to  alter  it  according  as  whether  it  be  too 
rich  in  carbohydrates  (in  which  case  a  more  albuminous 
food  should  be  substituted),  or  if  of  too  albuminous  a 
character,  then  look  out  a  suitable  food  of  a  more  starchy 
nature  to  take  the  place  of  one  which  contains  a  greater 
quantity  of  albuminoids  or  proteids. 


II.  The  Use  and  Abuse  of  Sedatives  in  the 
Treatment  of  the  Equine  Colics. 

Briefly  put,  it  may  be  said  that  the  major  portion  of 
this  little  monograph  is  a  plea  for  the  more  restricted 
use  of  sedatives  in  the  treatment  of  the  equine  colics. 
Seeing  that  it  is  more  or  less  a  summary  of  my  ideas  on 
the  subject,  and  that  it  contains  in  a  concise  form  the 
arguments  both  for  and  against  this  practice,  I  insert 
here  the  reprint  of  a  paper  which  I  read  in  1903  before 
the  members  of  the  Eastern  Counties  Veterinary  Medical 
Society. 

■x-  *  *  *  * 

'  There  are  two  factors  controlling  one's  choice  of  a 
subject  to  bring  before  the  members  of  an  Association 
such  as  this.  One  is  the  extent  to  which  it  should 
interest  the  hearers  ;  and  the  other  is  the  degree  of 
special  knowledge,  fancied  or  real,  the  essayist  feels  him- 
self capable  of  putting  into  it. 

The  first  condition  I  feel  confident  I  have  fulfilled,  for 
the  treatment  of  the  equine  colics  is  a  subject  that 
forces  itself  almost  daily  upon  the  average  veterinarian ; 
and,  unless  he  feels  his  present  treatment  the  acme  of 
what  is  right,  and  all  knowledge  bearing  on  it  at  a  stand- 
still, any  new  line  of  thought  thereon  should  not  fail  to 
hold  his  attention. 


236  tHE  COMMON  COLICS  OF  THE  HORSE 

Of  the  special  knowledge  I  am  able  to  offer  I  am  not 
so  sure.  One's  own  treatment  is  so  apt  to  become  what 
is  popularly  termed  'groovy';  and,  taking  the  line  I 
am  about  to,  I  expect  the  discussion  that  should  follow 
to  disabuse  me  of  wrong  impressions  or  point  out  errors 
in  judgment  that  a  long-continued  practice  of  a  special 
line  of  treatment  may  have  led  me  into. 

I  may  say  at  the  outset  that  I  consider  the  adminis- 
tration of  sedatives  in  colic  grossly  abused.  That  in  only 
a  very,  very  few  instances  are  they  called  for  at  all,  and 
that  in  all  other  cases  their  exhibition  tends  rather  to 
prolong  the  case  than  bring  about  its  resolution. 

Having  taken  that  standpoint,  I  shall  endeavour  to 
give  reasons  that  will  justify  it.  To  that  end  I  must 
arrange  the  matter  of  my  discourse  under  the  following 
headings : 

1.  The  sedatives  in  common  use,  and  their  generally 
accepted  actions. 

2.  Circumstances  that  have  led  the  veterinarian  to  their 
frequent  administration. 

3.  The  major  points  in  an  argument  for  their  more  re- 
stricted use. 

4.  Cases  of  colic  in  which  they  are  of  service. 

5.  Cases  of  colic  in  which  they  are  harmful. 

The  sedatives  in  common  use  are  opium  and  its 
alkaloid  morphia,  belladonna  with  its  alkaloid  atropine, 
chloral  hydrate,  and  cannabis  indica. 

Taking  these  in  the  order  named,  we  shall  find  that 
opium  and  morphia,  no  matter  how  administered,  para- 
lyze cutaneous  and  mucous  structures  and  the  ending  of 
sensory  nerves  with  which  they  are  brought  into  contact. 
Medicinal  doses  are  analgesic  and  anti-spasmodic,  and 
diminish  the  several  secretions,  excepting  that  of  the 
skin.     We  find  also,  though  there  is  some  primary  ex- 


APPENDIX  237 

citant  action,  that  they  more  notably  and  permanently 
diminish  gastro-intestinal  secretions  and  movements. 

Finlay  Dun,  the  author  of  the  work  I  have  taken, 
goes  on  to  state  that  they  are  useful  in  antagonizing 
muscular  spasm  in  spasmodic  colic — that  when  given 
for  that  purpose  they  should  be  combined  with  aloes, 
oil,  or  other  laxative,  to  counteract,  I  suppose,  though 
the  author  does  not  directly  say  so,  their  tendency 
to  cause  stagnation  of  the  bowels  and  consequent 
tympany. 

I  would  draw  your  attention  to  the  fact  that  he  does 
not  advocate  them  for  cases  of  obstruction,  except  as 
purely  expectant  treatment  in  cases  of  strangulation, 
intussusception,  and  obstruction  with  calculi.  Instead, 
he  commences  his  notice  of  their  medicinal  uses  by  say- 
ing emphatically,  '  Opium  and  morphia  are  used  to 
relieve  symptoms  rather  than  the  condition  on  which 
they  depend ' ;  and  on  a  later  page  we  find  the  direct 
statement  that  '  opiates  are  contra-indicated  in  cases  of 
obstinate  constipation.'  The  author,  by  the  very 
pointedness  of  the  last  sentence,  evidently  intends  it  as 
an  axiom  of  treatment,  and  not  as  a  rough  generali- 
zation. 

Belladonna  I  give  second  place  to  because  its  alkaloid, 
atropine,  is  so  frequently  combined  with  morphia  when 
that  latter  drug  is  given.  In  addition  to  the  fact  that  it 
has,  like  opium,  a  primary  stimulant  and  secondary 
paralyzant  action,  paralyzing  sensory  nerves  and  reliev- 
ing pain  and  sensibility,  there  is  little  to  note  save  that  it 
diminishes  the  secretions  of  all  glands — salivary,  per- 
spiratory, mucous,  and  mammary. 

Chloral  hydrate  is  also  described  as  having  a  primary 
stimulant  and  secondary  sedative  action.  It  is  claimed 
for  it  that  it  does  not  stay  intestinal  movements  and  call 


238  THE  COMMON  COLICS  OF  THE  HORSE 

up  tympany,  nor  hinder  secretion  of  the  intestinal  fluids. 
It  is  well  to  remember  also  that  this  drug  has  a  marked 
antiseptic  action,  almost  equalling  carbolic  acid  in  that 
respect,  and  that  it  has  an  irritant  action  on  the  skin 
and  mucous  membranes. 

Cannabis  indica,  a  deliriant  narcotic,  anodyne,  and 
anti- spasmodic,  is  said  to  relieve  pain  and  spasm  as 
quickly  as  opium,  but  more  permanently,  and  without 
arresting  the  action  of  the  bowels. 

Circumstances  which  have  led  the  Veterinarian 
to  the  Frequent  Administration  of  Sedatives. — Very 
probably  the  first  of  these  is  the  idea  that  anodynes  01 
sedatives  invariably  relieve  cases  of  uncomplicated  spasm 
— that  is  to  say,  '  uncomplicated  '  so  far  as  we  can  judge. 

Next  in  order  we  may  place  the  very  creditable  in- 
stinct that  urges  man  to  allay  pain  and  suffering  in  a 
dumb  animal. 

We  also  find  it  contended  that  in  colic  it  is  the  pain 
that  will  quickly  wear  the  animal  out — that  unless  we 
relieve  the  pain  the  patient  will  die,  not  as  a  direct 
result  of  the  malady  he  is  suffering  from,  but  actually 
from  the  pain  itself. 

So  far  as  I  can  gather,  those  are  the  arguments  ad- 
vanced favouring  the  frequent  use  of  sedatives  in  the 
cases  we  are  discussing.  I  w^ould  add  to  them,  however, 
that  peculiar  fear  some  practitioners  have  of  witnessing 
a  little  rolling  ;  that  absolute  dread  of  allowing  the 
pains,  even  as  symptoms,  to  manifest  themselves.  I 
would  even  go  so  far  as  to  state  that  it  is,  in  many  in- 
stances, a  fear  of  his  client's  opinion  that  urges  the 
veterinarian  to  a  course  he  would  naturally  reason  as 
wrong  if  not  unfairly  influenced.  The  client,  perhaps,  is 
standing  by — anxious,  alarmed.  He  suggests  that  the 
pains  should  be  stayed  ;  wonders  they  are  not.     '  Can 


APPENDIX  239 

nothing  be  done  ?'  he  may  ask.  The  veterinary  surgeon 
is  truthfully  bound  to  admit  that  a  dose  of  a  powerful 
sedative  will  alleviate  them.  At  the  same  time,  he  may 
know  that,  in  this  particular  case,  it  will  not  be  the  best 
treatment  possible.  He  is  conscious  of  the  fact  that  to 
drive  that  home  to  the  mind  of  a  layman  he  must  give 
a  lengthy  explanation.  He  doubts  whether,  should  his 
case  go  wrong,  his  explanation  would  be  accepted.  He 
wavers.  The  syringe  is  produced,  and,  hoping  to  please 
his  client,  the  agony  is  treated  instead  of  the  disorder. 
Does  not  that  mean  in  many  cases  that  the  sedative  is 
often  administered  to  cloak  the  practitioner's  want  of 
knowledge  —  administered  to  hide  a  pain  concerning 
whose  cause  there  is  blind  ignorance  ? 

Again,  those  who  have  given  this  subject  much  thought 
are  almost  certain  to  come  to  the  conclusion  that  the 
•  dread  of  enteritis '  often  wrongly  influences  the  prac- 
titioner to  the  administration  of  an  anodyne.  In  the 
horse  we  have,  in  enteritis,  a  form  of  colic  that  is,  per- 
haps, apart  from  contagiousness,  only  equalled  in  human 
medicine  by  cholera.  Its  rapid  fatality,  when  once  set 
in,  is  appalling.  With  one  or  two  recent  cases  of  that 
description  uppermost  in  his  mind,  the  veterinarian  at 
once  pushes  the  administration  of  sedatives  in  his  next 
case  of  acute  abdominal  pain.  And  yet  he  may  be  doing 
wrong.  I  hold  the  opinion,  rightly  or  wrongly,  that 
enteritis  as  we  know  it  is  a  form  of  acute  septic  infection 
of  the  blood-stream,  commencing  from  the  intestines, 
with  a  cause  as  yet  undiscovered.  And  if,  until  I  see 
its  fatal  signs  well  in  evidence,  I  withhold  the  adminis- 
tration of  sedatives  in  a  case  of  colic,  I  always  console 
myself  with  the  fact  that  their  earHer  exhibition  would 
not  have  helped  in  the  least  to  bring  about  a  favourable 
issue. 


240  THE  COMMON  COLICS  OF  THE  HORSE 

Allowing  these  influencing  circumstances  to  have 
arisen  solely  from  the  veterinarian's  own  experiences, 
I  fear  we  have  another  set  of  reasons  impelling  the 
veterinary  practitioner  to  a  use  of  sedatives  that  is  not 
only  extreme,  but  sometimes  fatal.  He  sees  or  hears  of 
their  frequent  use  in  human  medicine  for  apparently  like 
disorders,  and  argues,  falsely  in  this  case,  that  what  is 
good  for  man  is  good  for  beast.  Reasoning  from  analogy 
never  led  man  to  greater  error.  If  we  do  so  here,  we 
simply  cast  aside  all  our  knowledge  of  the  special 
anatomy  of  the  patient  with  which  we  are  dealing,  throw 
to  the  winds  all  our  special  information  regarding  his 
peculiarities  in  physiological  functions  and  processes,  and 
follow  as  mere  automatons  whatever  human  medicine 
says  is  right.  The  practitioner  of  human  medicine  is 
right  in  his  own  case.  It  does  not  follow  that  if  we  do 
as  he  does  we  are  right  in  ours. 

Major  Points  in  an  Argument  for  the  more 
Restricted  Use  of  Sedatives  in  Colic— Allowing  for 
the  moment  that  sedatives  will  relieve  uncomplicated 
spasm,  I  would  put  these  two  questions  to  the  members 
here  present.  How  often  is  it  that  we  are  called  in  to  a 
case  of  simple  spasmodic  colic  ?  If  we  are,  can  we  abso- 
lutely and  with  certainty  distinguish  it  at  once  from  a 
spasm  due  to  some  more  serious  cause  ? 

In  the  first  place,  most  of  you  will  agree  with  me  when 
I  say  that  the  case  of  uncomplicated  spasm  usually  gives 
way  to  some  first  remedy  administered  by  the  owner ; 
that  when  we  see  spasm  it  is  a  spasm  of  some  hours' 
duration,  and  therefore  due  to  some  fairly  serious  cause. 
In  other  words,  we  are  called  in  to  a  case  of  simple 
spasmodic  colic  seldom  or  never,  and  have,  therefore,  no 
reason  to  administer  a  sedative  at  all. 

Secondly,  I  think  you  will  again  agree  with  me  when 


Appendix  m^ 

I  say  that  our  present  means  of  differentiation  do  not 
allow  of  our  attending  a  case  of  colic  and  giving  a 
diagnosis  off-hand.  That,  therefore,  even  if  we  are  called 
in  early,  and  assume  it  to  be  a  case  of  simple  spasm,  the 
early  administration  of  a  sedative  will  not  be  wise.  The 
spasm  may  turn  out  to  be  due  to  faecal  obstruction,  in 
which  case  the  anodyne  will  do  harm  rather  than  good. 

This  all  seems  to  call  for  some  definition  of  the  words 
'  uncomplicated  spasm  ';  but  I  venture  to  think  that  any 
one  of  your  here,  when  discussing  the  equine  colics,  would 
hesitate  to  give  those  words  a  definite  limitation.  Given 
a  quickly  occurring  case  of  colic  which  an  anodyne 
rapidly  relieves,  the  practitioner  is  only  too  apt  to  care- 
lessly pass  it  over  as  '  spasm,'  without  a  due  inquiry  as 
to  a  possible  '  something '  of  which  the  spasm  may  have 
been  only  the  result. 

If  we  admit  that  spasm,  or  sudden  painful  contraction 
of  the  intestinal  muscular  coats,  comparable  with  the 
ordinary  cramp  of  voluntary  muscle,  is  likely  to  occur, 
then  the  name  of  simple  spasmodic  colic  may  still  be 
retained  in  our  nomenclature.  In  granting  that,  how- 
ever, we  grant  a  great  deal.  We  admit  that  this  sudden 
cramp  may  occur  as  a  result  of  continued  or  excessive 
work,  as  a  result  of  cold  or  other  equally  indefinite  cause, 
quite  independent  of  there  being  in  the  intestinal  tube 
poisonous  materials  generated  from  the  ingesta.  We 
admit  that  we  do  not  attempt  to  explain  the  cramp  as  a 
result  of  the  presence  of  food,  whose  very  bulkiness  or 
indigestibility  brings  it  about.  We  allow  that  no  tem- 
porary malarrangement  of  the  intestines  themselves  may 
be  blamed. 

Can  we  allow  all  this  ?  I  doubt  it.  Rather  would  I 
suggest  that  what  we  now  call  a  case  of  simple  or 
uncomplicated  spasm  is  one  in  which  the  materials  or 

i6 


242  THE  COMMON  COLICS  OF  THE  HORSE 

conditions  giving  rise  to  it  are  small  in  potency  or 
seriousness,  and  are  quickly  antagonized  by  a  sharp, 
quick  effort  on  the  part  of  the  bowel,  the  painful  mani- 
festation of  which  we  term  '  spasmodic  colic'  The  very 
fact  of  the  cause  not  being  a  serious  one  allows  a  sedative 
to  be  given.  The  cause  of  the  mischief  is  removed  by 
the  bowel,  while  the  sedative  dulls  the  outward  manifesta- 
tion of  the  pain.  In  this  case  the  bowels  act  in  spite  of 
the  sedative.  When  the  cause  is  a  serious  one,  then  this 
does  not  apply.  The  bowel  then,  hindered  in  its  actions 
by  the  administration  of  the  anodyne,  fails  to  act  as  in 
the  simpler  case,  and  an  obstinate  condition  of  intestinal 
stasis  is  bound  to  result.  As  we  cannot  always  say  at 
the  outset  of  a  case  whether  or  no  the  cause  is  a  simple 
one,  then  sedatives  had  better  be  withheld  entirely. 

Having  thus  disposed  of  the  value  of  sedatives  in 
simple  spasm — which,  after  all,  is  the  main  argument  to 
be  advanced  in  their  favour — we  come  to  several  circum- 
stances that  absolutely  negative  their  use  in  other  forms 
of  colic.  Before  an  assembly  of  practical  men  I  need 
not  dwell  over  them  long.  We  all  know  the  enormous 
length  of  the  horse's  intestines  and  the  large  masses  of 
food  they  are  called  upon  to  deal  with.  We  know  that 
the  amount  of  nutritive  material  abstracted  from  the 
large  masses  of  food  taken  in  is  comparatively  small, 
and  that,  therefore,  the  great  bulk  of  the  indigestible 
matter  has  to  be  kept  on  the  move  towards  its  exit  from 
the  body,  in  order  to  make  room  for  further  supplies. 
This  brings  us  to  the  known  fact  that  the  horse  requires 
to  pass  eight  to  ten  or  twelve  motions  daily  to  maintain 
his  health,  and  that  stoppage  of  his  peristaltic  action  for 
twenty-four  hours  is  about  equivalent  to  something  like 
eight  to  ten  days  in  man. 

This,  if  I  may  be  allowed  to  mention  what  I  have 


APPENDIX  243 

before  published,  should  lead  us  to  easily  understand  why 
it  is  that  pain  follows  so  rapidly  on  apparently  slight 
stasis  of  the  bowels  in  the  horse.  It  is  this  that  renders 
equine  colics  of  such  serious  importance.  It  explains  in 
great  measure  the  rapid  and  oftentimes  fatal  course 
they  run,  and  impressively  points  out  the  urgent  neces- 
sity for  prompt  and  precise  remedial  measures.  This, 
more  than  anything  else,  should  induce  the  veterinarian 
to  carefully  weigh  his  data  before  jumping  at  a  diag- 
nosis. Above  all,  it  should  cause  him  to  deliberately 
ponder,  and  perhaps  stay  his  hand,  before  administering 
those  agents  which  tend  to  kill  pain,  but  at  the  same 
time  tightly  lock  the  bowels.  It  should  cause  us  to 
reason  that  though  sedatives  may  be  administered  with 
comparative  impunity  to  man,  anything  that  may  tend 
to  stagnate  the  bowels,  which  a  sedative  undoubtedly 
will,  is  not  to  be  exhibited  with  safety  to  the  horse. 

To  those  who  administer  sedatives  with  the  humane 
object  of  alleviating  pain  I  have  only  one  remark  to 
make.  Their  first  duty  is  to  preserve  life,  even  if  in  so 
doing  they  inflict  a  little  more  suffering. 

Then  consider  the  nature  of  the  horse's  food.  It  is 
such  that,  if  locked  for  any  length  of  time  within  the 
bowels,  it  quickly  gives  rise  to  the  formation  of  gas.  In 
conjunction  with  that  fact  reflect  that  the  food  so  liable 
to  act  is  present  in  large  quantities,  and  we  see  that  this 
formation  of  gas  will  be  extensive.  Anyone  who  has 
seen  the  amount  of  tympany  called  up  by  a  dose  of  opium 
or  morphia  will  bear  me  out  in  that. 

We  should  next  pause  for  a  moment  over  the  question 
of  tympanitic  stomach — that  condition  in  which  the 
stomach  is  abnormally  distended  with  gas  that  is  gaining 
no  outlet  from  the  pylorus.  As  veterinarians  we  know, 
without  entering  into  details,  that  there  is  an  arrange- 

16 — 2 


244  T^HE  COMMON  COLICS  OF  THE  HORSE 

ment  of  the  fibres  of  the  cardiac  end  of  the  stomach 
walls  rendering  the  eructation  or  belching  up  of  the  gas 
by  road  of  the  oesophagus  an  utter  impossibility.  It 
must  gain  exit  from  the  body  by  way  of  the  intestines 
and  rectum,  or  accumulate  in  the  stomach  to  the  extent 
of  causing  rupture  of  that  organ  and  death.  Given  the 
gas  formation,  and  we  have  here  a  direct  danger  in  the 
administration  of  a  sedative,  a  danger  entirely  dependent 
on  the  anatomy  of  the  horse's  stomach.  We  lock  the 
natural  outlet,  namely,  the  intestines,  and  the  gases 
accumulate  in  the  stomach  to  a  degree  that  is  dangerous. 

I  may  be  met  with  the  argument  that  two  of  the  seda- 
tives I  have  mentioned  (chloral  hydrate  and  cannabis 
indica)  do  not  arrest  the  action  of  the  bowels.  To  that 
I  have  this  reply :  Those  two  certainly  are  not  the 
sedatives  in  common  use  among  veterinarians.  Opium 
and  morphia,  and  belladonna  and  atropine,  with  their 
dangerous  effects,  easily  run  a  good  first.  Putting  that 
on  one  side,  I  feel  it  hard  to  concieve  of  a  drug  which, 
while  diminishing  pain  and  sensibility  in  any  organ,  yet 
fails  to  influence  in  some  degree  or  other  that  organ's 
movements.  Chloral  hydrate  and  cannabis  indica  may 
not,  to  the  extent  of  opium  and  belladonna,  unfavourably 
affect  peristalsis.  Yet  no  one  will  deny  that  they  come 
under  the  same  class  of  drugs,  and  must,  in  common 
parlance,  be  'tarred  with  the  same  brush.' 

There  is  another  consideration,  this  time  a  selfish  one, 
that  should  concern  the  veterinarian  when  contempla- 
ting the  use  of  a  sedative  in  colic.  He  should  remember 
that  to  a  very  great  extent — an  extent  hardly  realized 
by  those  who  constantly  use  them — anodynes  efi"ectually 
mask  the  symptoms  of  the  animal's  complaint.  In  words 
I  once  heard,  '  There  is  no  real  art  in  reheving  pain. 
Anyone  with  a  few  grains  of  morphia  and  a  hypodermic 


APPENDIX  245 

syringe  may  do  that.  If  possible,  the  cause  of  the  pain 
should  be  the  first  consideration.'  If  the  veterinarian 
persists  in  the  administration  of  analgesics  in  equine 
colic,  he  cannot  expect  his  powers  of  diagnosis  to 
advance.  There  is  yet  so  much  to  learn  concerning 
these  troublesome  disorders  that  we  absolutely  cannot 
afford  to  throw  away  our  chances  of  acquiring  further 
knowledge.  And  yet  that  is  what  we  do  when  we 
administer  an  anodyne.  In  these  cases  the  only  evidence 
we  may  read  is  that  derived  from  the  symptoms  the 
animal  will  show.  Hide  these  by  a  dose  of  morphia  and 
we  are  face  to  face  with  a  closed  book.  If  I  may  carry 
the  metaphor  still  farther,  its  pages  are  often  closed 
beyond  our  power  to  reopen. 

To  those  who  still  remain  unconvinced  I  have,  in 
favour  of  the  general  correctness  of  my  conclusions,  one 
last  proof  to  offer,  and  it  is  one  that  might  well  be 
termed  a  'facer.'  It  is  this.  For  the  last  seven  years  I 
have  altogether  abandoned  sedatives  in  the  treatment  of 
colic,  with  the  best  results.  Instead,  I  have  relied  on 
large  doses  of  ammonium  carbonate  and  nux  vomica, 
aided  by  what  other  stimulant  the  cases  appeared  to 
demand.  The  details  of  that  treatment  I  need  not  enter 
into  here.  During  the  whole  of  those  seven  years  I  have 
seen  no  cause  to  regret  the  change.  My  cases  are  not  so 
long  about,  are  easier  diagnosed,  and  do  not  cause  the 
same  amount  of  anxiety,  while  my  list  of  fatalities  has 
decreased  to  an  eminently  gratifying  extent.  If  it  is  any 
inducement,  I  can  promise  the  same  happy  state  of  affairs 
to  those  who  may  follow  the  same  road. 

Though  these  by  no  means  exhaust  the  arguments  that 
might  be  advanced  against  the  extensive  employment  of 
sedatives  in  the  equine  colics,  the  time  at  my  disposal 
does  not  permit  of  their  further  mention.     I  think,  how- 


246  THE  COMMON  COLICS  OF  THE  HORSE 

ever,  that  I  have  now  said  enough  to  lead  those  here  who 
have  been  in  the  habit  of  so  using  them  to  give  the  sub- 
ject even  more  careful  thought  than  they  hitherto  may- 
have  done. 

Cases  of  Colic  in  which  Sedatives  are  of  Service. 
— Without  venturing  the  rash  statement  that  a  sedative 
is  never  of  use  in  an  attack  of  colic,  I  still  give  it  as  my 
firm  opinion  that  those  cases  in  which  it  may  be  used 
with  any  great  advantage  are  extremely  few  and  far 
between.     I  will  mention  the  chief. 

First  in  many  practices  will  come  the  colic  accompany- 
ing superpurgation  from  a  dose  of  aloes.  There  no 
difference  of  opinion  can  possibly  exist.  In  addition  to 
other  remedies,  a  dose  of  crude  opium  or  a  hypodermic 
dose  of  morphia  is  urgently  called  for,  and,  assuming  the 
case  not  to  have  advanced  too  far,  it  is  attended  with 
good  results.  Even  then  a  certain  amount  of  tympany 
will  often  result,  which,  however,  quickly  gives  way  to  a 
suitable  stimulant  treatment. 

Next  in  order  of  importance  will  come  that  form  of 
colic  arising  from  the  ingestion  of  irritating  foods,  as,  for 
example,  new  oats,  mouldy  or  mow-burnt  hay,  or  frozen 
roots,  in  which  purging  is  a  prominent  symptom.  We 
have  in  that  an  excited  and  irritated  condition  of  the 
bowel,  with  peristalsis  in  evidence  beyond  the  normal, 
and  a  sedative  that  does  not  too  actively  abate  the  peri- 
stalsis may,  perhaps,  be  given  with  benefit.  At  any  rate, 
it  will  stay  the  immediate  pains. 

Here,  however,  the  point  may  be  raised  as  to  whether 
this  purging  is  not  a  simple  effort  of  Nature  to  relieve 
the  system  of  the  offending  material.  It  might  even  be 
contended  that,  rather  than  check  her,  she  should  be 
assisted  in  so  relieving  herself  by  the  administration  of 
some  mild  diffusible  stimulant   combined  with  a  bland 


APPENDIX  247 

oleaginous  laxative.  In  using  the  sedative  there  is 
always  the  risk  of  slightly  over-estimating  the  correct 
dose  for  the  purpose,  thereby  staying  the  action  of  the 
bowels  just  a  trifle  too  far,  and  bringing  about  a  case  of 
intestinal  tympany  from  the  fermenting  ingesta  within. 
Though  the  tympany  called  up  in  this  manner  can 
hardly  be  regarded  as  serious,  it  is  questionable  whether 
the  treatment  has  been  a  rational  and  a  scientific  one. 
As  the  case,  then,  is  just  a  little  open  to  question,  I  give 
the  supporters  of  sedatives  the  benefit  of  the  doubt,  and 
allow  that  an  anodyne  will,  in  this  instance,  relieve  the 
pain  vv^ithout  doing  serious  harm. 

Peritonitis  is  another,  though  less  frequent,  form  of 
colic  that  will  benefit  by  the  administration  of  an  anal- 
gesic. So  far  I  have  met  with  only  one  or  two  isolated 
cases,  one  of  which  resulted  from  the  use  of  the  trocar 
and  cannula  in  a  case  of  intestinal  tympany.  Even  here 
a  sedative,  as  we  generally  understand  a  sedative,  is  not 
going  to  be  the  most  suitable  remedy.  Aconite,  with  its 
powers  of  rapidly  reducing  the  pulse-beats,  lowering  the 
temperature,  and  lessening  the  perceptions  of  pain,  will 
be  found  the  most  beneficial. 

We  now  come  to  another  mention  of  enteritis,  that 
bogey  of  the  veterinarian,  and  the  cause  of  certainly 
more  than  half  of  the  mistreatment  of  veterinary  colic. 
When  once  diagnosed,  of  course  sedatives  may  be  given 
with  a  lavish  hand  in  order  to  deaden  the  agonizing 
pains  that  assuredly  herald  the  animal's  speedy  death. 
But  that  which  is  diagnosed  as  enteritis — is  it  always 
enteritis  ?  Those  among  us  of  any  length  of  experience, 
as  they  call  to  memory  the  cases  of  their  earlier  days, 
are  bound  to  admit  that  it  is  not.  More  especially  to 
the  young  beginner  will  this  hoary-headed  misnomer 
rear  his  grinning  features  and  rattle  his  clanking  chains, 


248  THE  COMMON  COLICS  OF  THE  HORSE 

Confronted  with  a  case  of  acute  agonizing  pain,  the 
young  graduate  becomes  alarmed.  Enteritis,  with  all 
the  tales  of  dread  fatality  its  name  calls  up,  flits  across 
his  mind.  His  case  is — he  is  certain  it  is — enteritis.  He 
commences  at  once  the  administration  of  sedatives. 
What  is  the  result  ?  Everyone  knows  that  a  case  of 
subacute  intestinal  obstruction  may  commence  with 
extremely  acute  symptoms,  and  then  linger  on  with  dull 
pains  for  days.  What  in  reality  was  the  sharp  paroxysm 
denoting  a  belated  attempt  of  the  bowel  to  deal  with 
a  mass  of  obstructive  matter  has  been  treated  with  an 
anodyne,  the  bowel  being  thus  deadened  to  the  serious 
nature  of  its  condition,  and  the  gravity  of  the  case  of 
obstruction  rendered  a  certainty. 

Were  it  a  proved  fact  that  the  administration  of  seda- 
tives would  bring  about  resolution  in  a  case  of  this  so- 
called  enteritis  I  could  find  some  excuse  for  this  error. 
If  one  case  only,  and  that  an  unquestionable  one,  were 
on  record  of  a  cure  being  so  brought  about,  I  would  again 
risk  falling  into  that  error  myself.  But  it  is  not  so. 
There  is  not,  and  never  has  been,  an  instance  in  which 
sedatives  have  had  a  beneficial  action  and  changed  the 
issue  in  an  tindoubted  case  of  enteritis.  If  only  that 
teaching  were  generally  accepted,  acute  pain  w^ould  not 
then  frighten  the  practitioners  into  the  too  early  adminis- 
tration of  anodynes,  and  one  great  factor  leading  to  their 
abuse  in  the  treatment  of  colic  would  be  entirely  done 
away  with. 

Cases  of  Colic  in  which  Sedatives  are  Harmful. 
— Among  the  abuses  of  sedatives  there  is,  to  my  mind, 
nothing  worse  than  the  case  of  their  administration  in 
subacute  obstructions  of  the  colon.  These  are  the  cases 
that  form  so  large  a  percentage — probably  80  or  go — 
of  our  total  attacks  of  colic,  so  that  if  in  his  treatment  he 


APPENDIX  249 

is  labouring  under  a  misapprehension,  the  practitioner 
will  have  the  great  bulk  of  his  cases  suffer,  and  not  the 
comparatively  few.  The  very  thing  we  are  called  upon 
to  treat  in  these  cases  is  a  lethargic,  torpid  condition  of 
the  bowel,  and,  unless  we  are  homoeopaths,  believing  in 
the  dictum  similia  similihiis  ciiranUiv  (let  likes  be  treated 
by  likes),  we  cannot,  with  any  regard  for  logic,  administer 
an  anodyne. 

Those  who  have  met  with  them  will  have  noticed  that 
obstructions  confined  to  the  single  colon  give  rise  to  a 
condition  of  the  bowel  even  more  obstinately  torpid  than 
that  arising  from  a  like  affection  of  the  larger  bowel, 
in  which  case  a  sedative  is  even  more  strongly  contra- 
indicated  still. 

In  justice  to  those  who  give  anodynes  in  these  cases, 
it  is  only  fair  to  add  that  they  administer  at  the  same 
time  a  drastic  purgative  in  the  shape  of  aloes.  They 
say  in  support  of  their  treatment  that  an  anodyne  will 
stay  the  pains  while  the  purgative  removes  the  cause — 
viz.,  the  obstruction.  In  so  believing  they  lull  them- 
selves into  a  state  of  false  security.  The  anodyne,  in 
addition  to  staying  the  pain,  stays  the  action  of  the  aloes 
and  the  bowels.  In  this  way  the  cause  is  still  retained, 
and  the  case  prolonged  or  even  aggravated. 

Gastric  tympany  I  have  already  touched  on,  and  have 
pointed  out  that  the  arrangement  and  anatomy  of  the 
horse's  stomach,  when  it  is  filling  with  gas,  will  not  allow 
of  any  agent  being  given  that  will  tend  to  stay  the  normal 
movements  of  the  intestines. 

In  tympanites  confined  to  the  intestines  themselves 
sedatives  are  just  as  dangerous.  This  is  another  form  of 
colic  due  to  the  ingestion  of  irritating  and  fermenting 
foods,  this  time  unaccompanied  by  a  relieving  purge. 
The  volume  of  gas  distends  the  intestine  to  a  point  of 


250  THE  COMMON  COLICS  OF  THE  HORSE 

agonizing  pain,  may  even,  by  force  of  pressure,  interfere 
with  the  movements  of  the  lungs,  bringing  about  a 
deoxygenated  state  of  the  blood,  or  even  a  species  of  in- 
toxication from  the  absorption  of  the  gas  itself.  Nothing 
but  a  speedy  removal  of  the  gases  from  the  system 
will  restore  the  body  tone  to  a  state  competent  to  fight 
against  the  disorder.  A  sedative  will  not  remove  but 
lock  them  there,  at  the  same  time  causing  the  retention 
within  the  intestines  of  the  very  matter  from  which  the 
gases  are  arising. 

Throughout  this  paper  it  will  be  noticed  I  have  re- 
frained from  mentioning  such  forms  of  colic  as  volvulus, 
intussusception,  the  action  of  poisons,  parasitic  embolism 
of  the  mesenteric  bloodvessels,  etc.  I  do  not  think 
these  cases  occur  with  such  a  frequency  as  should  lead 
us  to  confound  their  treatment  with  that  of  the  more 
simple  forms.  The  fact  that  a  sedative  is  needed  by 
conditions  thus  serious  should  not  cause  us  to  aimlessly 
blunder  forward,  sedative  in  hand,  to  every  case  of  colic 
we  encounter. 

This,  gentlemen,  concludes  my  plea  for  the  more  cau- 
tious and  restricted  use  of  sedatives  in  the  treatment  of 
the  equine  colics.  I  cannot  claim  that  I  have  covered 
the  whole  of  the  ground  the  title  of  my  paper  would 
suggest,  or  that  I  have  said  even  one  quarter  of  what 
might  be  said  on  this  very  important  subject,  for  it  is 
extremely  difficult — nay,  impossible — to  condense  within 
the  limits  of  a  single  paper  the  whole  line  of  reasoning 
that  leads  one  to  a  conclusion  involving  this  so  radical 
a  change  in  our  therapeutic  methods.  I  can  only  pre- 
tend to  have  given  you  the  merest  outline.  In  any  case 
where  they  think  I  have  been  too  self-assertive  or  too 
dogmatic,  I  wish  my  hearers  to  fully  understand  that 
dogmatism   does   not    necessarily   imply   arrogant   self- 


APPENDIX  251 

conceit,  or  even  the  assumption  of  a  superior  knowledge. 
In  this  case  it  means  that  the  speaker  thinks  he  has 
placed  his  fingers  on  a  weak  spot  in  the  generally  ac- 
cepted treatment  of  a  certain  set  of  complaints.  It  means 
also  that  towards  anything  approaching  an  innovation 
he  dimly  detects  a  certain  degree  of  apathy  among  his 
fellow-practitioners,  and  recognises  that  a  certain  amount 
of  plain  speaking  is  the  one  thing  calculated  to  stir  them 
into  wakefulness  concerning  it. 

If  in  coming  here  I  make  but  one  convert,  I  shall  feel 
the  time  has  been  well  spent.  If,  again,  the  discussion 
proves  certain  conclusions  of  mine  to  be  wrong,  or  shows 
where  my  enthusiasm  for  a  new  thing  should  be  moderated, 
my  time  will  have  been  even  better  spent. '^ 

III.  Further  Remarks  on  the  Use  of  Aloes  in  the 
Treatment  of  Intestinal  Impactions. 

In  this,  the  second  edition  of  this  little  book,  pub- 
lished in  1909,  I  wish  to  qualify  the  strictures  placed  on 
aloes  in  the  earlier  edition.  Since  the  first  publication  of 
this  work  in  1902  my  views  concerning  the  use  of  this 
drug  in  the  treatment  of  the  equine  colics  have  become 
somewhat  modified,  and  I  should  not  be  honest  did  I 
not  here  admit  the  change. 

At  first  I  contemplated  re-writing  the  matter  occurring 
under  this  head  in  the  several  places  in  this  book.  For 
one  or  two  reasons,  however,  I  prefer  to  let  it  stand,  and 
give  explanation  here.  In  the  first  place,  the  reader 
will  be  able  to  compare  what  has  been  written  before 
with  the  remarks  I  have  now  to  make.  Secondly,  the 
matter  on  pages  96  and  97  and  in  Chapter  XVII. 
contains  so  much  that  is  true  that  it  should  be  allowed 

^  The  Veterinary  Record,  March  21,  1903. 


252  THE  COMMON  COLICS  OF  THE  HORSE 

to  remain,  if  only  to  serve  as  a  reminder  that  the  use  of 
aloes  should  be  tempered  with  the  greatest  caution  and 
judgment. 

The  most  serious  objection  I  saw  at  that  time  to  the 
employment  of  aloes  was  that  its  early  administration  in 
cases  of  intestinal  obstruction  prevented  me  from  after- 
wards persisting  in  the  vigorous  stimulant  treatment  I 
deemed  those  cases  necessitated.  What  I  always  feared 
was  that  a  stimulant  treatment  following  close  on  the 
administration  of  aloes  should  induce  a  fatal  attack  of 
superpurgation  (see  Chapter  XVII.). 

So  grave  an  objection  did  I  find  this  that  I  altogether 
discarded  aloes,  and  for  several  years  used  only  linseed 
oil,  this,  to  my  mind,  being  a  safer  and  less  drastic 
method  of  bringing  about  the  requisite  softening  of  the 
bowel  contents.  In  a  great  many  cases,  in  fact,  I  used 
no  aperient  at  all,  but  relied  solely  on  the  stimulants. 

From  this  last  statement  I  hope  it  will  not  be  inferred 
that  I  believe  the  one  half  of  a  correct  method  of  treating 
intestinal  obstruction  to  consist  in  withholding  aperients 
altogether.  What  I  have  published  before  will  show 
that  not  to  be  the  case.  Such  a  method,  in  fact,  would 
be  irrational  to  a  degree,  and  I  only  practised  it  in  a 
long  series  of  cases  in  order  to  quite  convince  myself 
that  the  stimulant  treatment  which  I  so  strongly 
advocated  was  based  on  a  sure  foundation. 

It  speaks  much  for  the  rationality  of  that  treatment 
that  for  quite  a  long  while  I  was  able  in  this  manner  to 
deal  successfully  with  cases  of  obstinate  impaction.  That 
I  was  successful  I  proved  to  myself  by  making  a  practice 
for  some  considerable  time  of  attending  the  post-mortem 
of  every  case  I  had  die  from  'colic'  Practically  no 
death  occurred  which  I  was  unable  to  trace  to  some 
other  cause  very  much  more  grave  than  that  of  mere 


APPENDIX  253 

obstruction,  the  most  common  cause  of  all  being  that 
of  twist  or  serious  displacement  of  the  double  colon. 

Once  that  point  was  proved,  I  was  open  again  to 
include  in  my  list  of  remedies  any  aperient  that  could 
be  safely  used  in  conjunction  with  what  was  to  me  the 
major  portion  of  the  treatment.  Always  I  had  seen  that 
the  administration  of  the  linseed  oil,  although  successful, 
was  'inconvenient,'  and  not  infrequently  attended  with 
difficulty,  as,  for  instance,  in  an  animal  awkward  to 
drench.  I  thereupon  determined  to  give  aloes  a  further 
trial,  if  only  on  account  of  the  greater  ease  with  which 
it  might  be  administered. 

Seeing  that  I  had  proved  to  myself  I  could  dispense 
with  any  aperient  at  all,  and  that  without  serious 
prejudice  to  the  patient  I  was  treating,  I  resolved  to 
commence  with  quite  small  doses.  Accordingly,  I 
started  with  a  dose  which  many  in  the  habit  of  pre- 
scribing aloes  regularly  would  deem  absurd.  Gradually 
I  raised  it,  however,  until  I  arrived  at  the  maximum 
dose  which  I  found  could  be  administered  simultaneously 
with  full  doses  of  stimulants. 

This  dose  I  found  for  a  gross,  heavy  cart  animal, 
suffering  from  impaction,  to  be  six  drachms.  For  a  nag 
in  the  same  condition,  I  found  five  drachms  to  be  equally 
sufficient.  These  doses,  although  acting  freely  at  times, 
do  not  always  create  that  excessive  evacuation  the 
average  stableman  likes  to  see.  They  prove  amply 
sufficient,  however,  to  favourably  influence  a  case  of 
obstruction,  and  that  with  safety. 

We  may  sum  up,  then,  as  follows :  In  dealing  with 
intestinal  impaction  in  the  horse,  the  stimulant  treatment 
{tvhich  excludes  the  use  of  any  sedative  whatever)  is  not  only 
logical  in  theory,  but  bears  the  test  of  actual  practice. 
At  the  same  time  there  should  be  exhibited  an  aperient. 


254  THE  COMMON  COLICS  OF  THE  HORSfi 

sufficiently  powerful  to  favourably  influence  intestinal 
secretion,  but  not  of  such  potency  as  to  prevent  an  active 
stimulant  treatment  being  afterwards  adopted.  Of  these 
we  have  the  choice  of  two  that  are  equally  reliable. 
One,  linseed  oil,  mild  in  its  action,  may  be  used  freely, 
without  fear  of  untoward  result.  The  other,  aloes,  must 
be  used  with  comparative  caution. 

The  strictures  heretofore  placed  on  aloes  must  therefore 
be  read  in  the  light  of  this  later  experience.  That  their 
circulation  in  the  earlier  edition  of  this  book  has  served 
to  point  out  to  others  the  value  of  a  solely  stimulant 
treatment  I  am  in  the  happy  position  of  being  fully 
assured."^  For  that  reason,  and  that  they  may,  perhaps, 
serve  the  same  purpose  again,  I  have  allowed  them  to 
stand.  Simply,  I  tack  on  this  addendum  and  give  the 
practitioner,  with  his  case  before  him,  and  with  the 
advantages  and  disadvantages  of  either  method  duly 
weighed,  the  onus  of  making  choice. 

After  all  is  said  and  done,  the  question  as  to  which  of 
two  aperients  one  should  use  is  only  a  detail  of  minor 
importance  in  that  treatment  of  equine  intestinal  impac- 
tion which  it  is  the  main  motif  of  this  book  to  advocate. 
That  treatment  this  qualification  concerning  aloes  is  not 
intended  to  afifect  at  all. 

^  See  Preface  to  the  Second  Edition. 


INDEX 


Abdomen,  surgical  regions  of,  6 
Abdominal   incision,    position  of, 
in  laparo-enterotomy,  177 
organs,   tabular  arrangement 
of,  15 
Aloes   and   opium  inadvisable  in 
intestinal  impaction,  96,  102 
in  intestinal  impaction,  96 
Ammonium  carbonate  in  intestinal 
impaction,  98 
hydrate  in  gastric  tympany,  66 
Anatomical  predisposing  causes  of 

colic,  29,  30 
Anatomy  of  the  stomach,  8,  17 
Antizymotics  in  gastric  tympany, 
67 
intra-intestinal  injection  of,  in 
tympanites,  197 
Auscultation,  25 

Bowel,  incision  and  suture  of,  179" 
puncturing  for  intestinal  tym- 
pany. 193 

Bowels,  inflammation  of,  200 
stoppage  of,  80 

Calculus  in  small  colon,  187 
Cardiac  sphincter,  illustration  of, 

17,  18,  19 
Care  in  diagnosis,  21 
Case  of  gastric  tympany,  6g 
Cases  of  subacute  obstruction  of 
double  colon,  108,  122 
small  intestines,  156,  157 
Cause,  exciting,  of  intestinal  im- 
paction, 93 


Cause  of  pain  in  intestinal  impac- 
tion, 93 
Causes,  anatomical  predisposing, 
of  colic,  29,  30 
of  enteritis,  203 
of  gastric  impaction,  48 

tympany,  54 
of  intestinal  tympany,  189 
of  ruptured  stomach,  73 
of  subacute  obstruction  of  the 
double  colon,  82 
pelvic  flexure  of  the  colon, 

124 
single  colon,  137 
small  intestines,  147 
of  superpurgation,  213 
physiological  predisposing,  of 
colic,  28,  31 
Caution  against  use  of  sedatives, 
31,  68,  102,  210 
in  gastric  tympany,  68 
Chloral  hydrate  in  intestinal  im- 
paction, 103 
in  superpurgation,  216 
Classification     of    equine    colics 

(Friedberger's),  2 
Colic,     anatomical     predisposing 
causes  of,  29,  30 
caused    by    intestinal    septic 

infection,  45,  203 
comparison    of   human   with 

equine,  4,  32 
flatulent,  189 
Friedberger's      classification 

of,  2 
its  derivation,  i 


255 


256 


THE  COMMON  COLICS  OF  THE  HORSE 


Colic,  physiological   predisposing 
causes  of,  28,  31 
treatment  of,  in  foals,  221 
in    yearlings     and     two- 
year-olds,  219 
Colon,  calculus  in  small,  187 

intestinal  irrigation  in  obstruc- 
tion of,  161 
the,  13 

single,  14 
Comparison  of  human  with  equine 
colic,  4,  32 

Danger  in  over-ripe  grasses,  48 
of  sedatives   in  gastric  tym- 
pany, 68 
Definition  of  enteritis,  200 
of  gastric  impaction,  47 

tympany,  52 
of  intestinal  tympany,  189 
of  ruptured  stomach,  73 
of    subacute    obstruction    of 
double  colon,  80 
pelvicflexure  of  the  colon, 

123 
single  colon,  137 
small  intestines,  147 
of  superpurgation,  213 
Derivation  of  colic,  i 
Diagnosing,    history   of   case    in, 

22 
Diagnosis,  care  in,  24 
of  enteritis,  206 
of  gastric  impaction,  50 

tympany,  59 
of  intestinal  tympany,  191 
of  ruptured  stomach,  76 
of    subacute    obstruction    of 
double  colon,  86 
pelvicflexure  of  the  colon, 

131 

single  colon,  142 
small  intestines,  152 
of  superpurgation,  215 
respiratory  movements  in,  23 
Diagrams  of  incisions  in  operation 

of  laparo-enterotomy,  177,  178 
Diarrhoea,  treatment  of,  in  young 

animals,  222 
Dilatation  of  the  stomach,  52 


Domestication  an  exciting  cause 

of  colic,  35 
Double  colon,  cases  of  subacute 
obstruction  of,  108,  122 
subacute  obstruction  of,  80 
Duodenal  S-trap,  10,  11 

Enteritis,  200 

causes  of,  203 
definition  of,  200 
diagnosis  of,  206 
prognosis  of,  208 
sedatives  in,  209 
symptoms  of,  205 
treatment  of,  209 
or  intestinal  septic  infection, 
203 
Enterocentesis  in  intestinal  tym- 
pany, 192 
seat  of,  194 
Equine     colic     compared     with 

human,  4,  32 
Errors  in  stable-management  pro- 
ductive of  colic,  36 
Eructation  in  gastric  tympany,  58 
Eserine   in   intestinal    impaction, 
100,  144 
value  of,  in  gastric  tympany, 
69 
Examination  of  the  patient,  21 
Exciting  cause  of  colic,  domestica- 
tion an,  35 
food  as  an,  36 
water  as  an,  37 
of  intestinal  impaction,  93 
Exploration,  rectal,  26 
External  incision  in  laparo-entero- 
tomy, 177 

Flatulent  colic,  189 

Foals,  treatment  of  colic  in,  221 

Food  as  an  exciting  cause  of  colic, 

36 
Friedberger's      classification      of 

equine  colics,  2 

Gases  present  in  gastric  tympany, 

65 
Gastrectasis,  52 
Castric  impaction,  47 


INDEX 


257 


Gastric  impaction,  causes  of,  48 

definition  of,  47 

diagnosis  of,  50 

prognosis  of,  50 

symptoms  of,  49 

treatment  of,  50 
Gastric  tympany,  52 

ammonia  in,  66 

antizymotics  in,  66 

case  of,  69 

causes  of,  54 

danger  of  sedatives  in,  68 

definition  of,  52 

diagnosis  of,  59 

eructation  in,  58 

gases  present  in,  65 

hydrate  of  iron  in  treatment 
of,  66 

prognosis  of,  64 

symptoms  of,  56 

treatment  of,  65 

vomition  in,  59,  65 
Gorged  stomach,  47 
Grass  staggers,  47 
Grasses,  danger  in  over-ripe,  48 

Heredity  a  predisposing  cause  of 

cohc,  33 
Hernia,    strangulated,    in    young 

animals,  226 
Hindrances  to  vomition,  29,  30 
History   of  case    in    diagnosing, 

22 
Hoven,  53 
Human    compared    with    equine 

colic,  4,  32 
Hydrate  of  iron  in  treatment  of 

gastric  tympany,  66 

Impaction,  gastric,  47 

causes  of,  48 

definition  of,  47 

diagnosis  of,  50 

prognosis  of,  50 

symptoms  of,  49 

treatment  of,  50 
Impaction,  intestinal,  80 

exciting  cause  of,  93 

in  young  animals,  225 

of  double  colon,  80 


Impaction  of  pelvic  flexure  of  the 
double  colon,  123 
of  single  colon,  137 
of  small  intestines,  147 
sedative  treatment  of,  89,  102 
stimulant    treatment    of,   92, 

143.  154 
Incision    and    suture    of    bowel, 

179 
Inflammation  of  the  bowels,  200 
Influence  of  time  of  day  on  pro- 
duction of  colic,  43 
Injection,  intra-intestinal,  of  anti- 
zymotics in  tympanites,  197 
Inspection  of  patient,  mode  of,  21 
preliminary,  in  young  animals, 
220 
Intestinal  impaction,  aloes  in,  96 
ammonium  carbonate  in,  98 
cause  of  pain  in,  93 
chloral  hydrate  in,  103 
eserine  in,  100,  126 
exciting  cause  of,  93 
in  young  animals,  225 
nux  vomica  in,  99 
reasons  against  use  of  seda- 
tives in,  102 
sedative  treatment  of,  89,  102 
stimulant    treatment    of,    92, 

143.  154 
turpentine,  in,  100 
Intestinal  irrigation,  case  treated 
by,  162,  169 
in  obstructions  of  the  colon, 

161 
obstructions,    surgical    treat- 
ment of,  173 
septic    infection    a   cause    of 
colic,  45,  203 
of  enteritis,  203 
Intestmal  tympany,  1S9 
causes  of,  189 
definition  of,  189 
diagnosis  of,  191 
enterocentesis  in,  192 
prognosis  of,  192 
puncture  of  bowel  in,  192 
sedatives  in,  199 
symptoms  of,  190 
treatment  of,  192 

17 


258 


THE  COMMON  COLICS  OF  THE  HORSE 


Intestines,  tlie  large,  12 
the  small,  11 
impaction  of  the,  So 
Intra-intestinal  injection  of  anti- 

zymotics  in  tympanites,  197 
Iron,  hydrate  of,  in  treatment  of 
gastric  tympany,  66 

Kidneys,  the,  15 
Knisely's  stomach-tube,  71 

Laparo-enterotomy,    diagrams   of 
incisions  in,  177,  178 
materials  required  for  opera- 
tion of,  174 
preparation   of  materials   re- 
quired for,  175 
Large  intestine,  12 
Lembert's  sutures,  180 
Liver,  the,  14 

Materials  required  for  the  opera- 
tion of  laparo-enterotomy,  174 

Methods  of  watering  horses,  38 

Mode  of  inspection  of  patient  in 
colic,  21 

Morphia  in  superpurgation,  216 

New  oats  as  cause  of  gastric 
tympany,  54 

Nux  vomica  in  intestinal  impac- 
tion, 99 

Oats,  new,  cause  of  gastric  tym- 
pany, 54 
Obstruction,   case  of,  treated   by 

intestinal  irrigation.  162,  169 
Obstruction   of  small    intestines, 
cases  of,  156.  157 
causes  of,  146 
definition  of,  146 
diagnosis  of,  152 
prognosis  of,  153 
purging  in,  150 
rectal  exploration  in,  150 
symptoms  of,  148 
treatment  of,  153 
Obstruction  of  the  colon,  intestinal 

irrigation  in,  161 
Obstruction,  subacute,  of  double 
colon,  80 


Obstruction,  subacute,  of  double 
colon,  causes  of,  82 
definition  of,  80 
diagnosis  of,  86 
prognosis  of,  88 
symptoms  of,  83 
treatment  of,  89 
Obstruction,   subacute,    of  single 

colon,  137 
Obstruction,    subacute,    of   small 

intestines,  147 
Obstruction,  subacute,   of   pelvic 
flexure  of  colon,  123 
causes  of,  124 
definition  of,  123 
diagnosis  of,  131 
prognosis  of,  133 
symptoms  of,  129 
treatment  of,  134 
Obstructions,   intestinal,    surgical 

treatment  of,  173 
(Esophagus  tube  in  gastric  tym- 
i        pany,  71 
Operation   of  laparo-enterotomy, 

i        177 

I    Opium  in  superpurgation,  217 

Opium  and  aloes  in  intestinal  im- 
paction, reasons  against,  96,  103 

Over-ripe  grasses,  danger  in,  48 

Pain,  cause  of,  in  intestinal  im- 
paction, 93 

Pancreas,  the,  14 

Paralysis  of  rectum,  139,  143 

Passage  of  food  through  the  diges- 
tive canal  of  horse,  time  occupied 
in,  31 

Patient,  mode  of  inspection  of,  21 

Pelvic  flexure  of  colon,  subacute 
obstruction  of,  123 

Percussion  in  diagnosis,  27 

Peritoneum,  the,  8 

Physiological  predisposing  causes 
of  colic,  28,  31 

Physostigmine  in  intestinal  im- 
paction, 100,  135,  144 

Position  of  abdominal  incision  in 
laparo-enterotomy,  177 

Predisposing,  anatomical,  causes 
of  colic,  29,  30 


INDEX 


259 


Predisposinff,  physiological, 
causes  of  colic,  28,  31 

Preliminary  inspection  when  diag- 
nosing in  young  animals,  220 

Preparation  of  materials  for  opera- 
tion of  laparo-enterotomy,  175 

Prevention  of  ruptured  stomach, 

79 
Prognosis  of  enteritis,  208 
of  gastric  impaction,  50 

tympany,  64 
of  intestinal  tympany,  192 
of  ruptured  stomach,  78 
of    subacute    obstruction    of 
double  colon,  88 
pelvic   flexure  of  double 

colon,  133 
single  colon,  143 
small  intestines,  153 
of  superpurgation,  216 
Pulse,  the,  24 
Puncturing  the  bowel  in  intestinal 

tympany,  193 
Purgative,    aloetic,    in    intestinal 

impaction,  89,  96 
Purging  in  subacute  obstruction 
of  the  small  intestines,  150 

Reasons  against  use  of  sedatives 
in  intestinal  impaction,  32,  102 
Rectal  exploration,  26 

in    subacute    obstruction    of 
small  intestines,  150 
Rectal  paralysis,  treatment  of,  143 
Rectal  tube.  Smith's,  146,  162 
Respiratory  movements  in  diag- 
nosis, 23 
Ruptured  stomach,  73 

causes  of,  73 

definition  of,  73 

diagnosis  of,  76 

prevention  of,  79 

prognosis  of,  78 

symptoms  of,  74 

S-trap,  duodenal,  10,  ir 
Seat  of  enterocentesis,  194 
Sedatives,  caution  against  use  of, 
31,  68,  102,  210 
in  enteritis,  209 


Sedatives  in  gastric  tympany ,  68 
in    intestinal    impaction,    89, 

102 
in  intestinal  tympany,  199 
in  superpurgation,  216 
Septic  intestinal  infection  as  cause 

of  colic,  45,  203 
Single  colon,  subacute  obstruction 
of,  136 
causes  of,  136 
definition  of,  136 
diagnosis  of,  142 
prognosis  of,  143 
symptoms  of,  139 
treatment  of,  143 
Single  colon,  calculus  in,  187 
Small  intestines,  11 

subacute  obstruction  of,  147 
cases  of,  156,  157 
causes  of,  147 
definition  of,  147 
diagnosis  of,  152 
prognosis  of,  153 
purging  in,  150 
rectal  exploration  in,  150 
symptoms  of,  148 
treatment  of,  153 
Smith's  rectal  tube,  146,  162 
Spleen,  the,  14 

Stable-management    errors,    pro- 
ductive of  colic,  36 
Staggers,  grass,  47 

stomach,  47 
Stimulants      in     superpurgation, 

217 
Stimulant  treatment  of  intestinal 
impaction,  92 
Mr.  Harding  on,  118 
Stomach,  anatomy  of  the,  9,  17 
dilatation  of  the,  52 
gorged,  47 
rupture  of  the,  73 
causes  of,  73 
diagnosis  of,  76 
prevention  of,  79 
prognosis  of,  78 
symptoms  of,  74 
staggers,  47 
Stomach-tube,  Knisely's,  71 
Stoppage  of  the  bowels,  80 
17 — 2 


26o 


THE  COMMON  COLICS  OF  THE  HORSE 


Strangulated     hernia     in     young 

animals,  226 
Subacute    obstruction   of   double 
colon,  80 

cases  of,  loS,  122 

causes  of,  82 

definition  of,  80 

diagnosis  of,  86 

prognosis  of,  88 

symptoms  of,  83 

treatment  of,  8g 
Subacute    obstruction    of    pelvic 
flexure  of  colon,  123 

causes  of,  124 

definition  of,  123 

diagnosis  of,  131 

prognosis  of,  133 

symptoms  of,  129 

treatment  of,  134 
Subacute    obstruction    of    single 
colon,  137 

causes  of,  137 

definition  of,  137 

diagnosis  of,  142 

prognosis  of,  143 

symptoms  of,  139 

treatment  of,  143 
Subacute  obstruction  of  small  in- 
testines, 147 
Superpurgation,  212 

causes  of,  213 

chloral  hydrate  in,  216 

definition  of,  212 

diagnosis  of,  215 

morphia  in,  216 

opium  in,  217 

prognosis  of,  216 

stimulants  in,  217 

treatment  of,  216 
Surgical     regions     of     abdomen 

(Smith),  6 
Surgical    treatment  of  intestinal 

obstructions,  173 
Sutures,  Lembert's,  180 
Suturing  incision  of  bowel,  179 
Symptoms  of  enteritis,  205 

of  gastric  impaction,  49 
tympany,  56 

of  intestinal  tympany,  190 

of  ruptured  stomach,  74 


Symptoms  of  subacute  obstruction 
of  double  colon,  83 
of  single  colon,  139 
of  small  intestines,  148 
of   the   pelvic  flexure  of  the 
double  colon,  129 

Tabular  arrangement  of  abdominal 

organs,  15 
Temperament  a  predisposing  cause 

of  colic,  34 
Temperature,  the,  24 
The  anatomy  of  the  stomach,  8, 

17 
The  colon,  13 
kidneys,  15 
large  intestines,  12 
liver,  14 
pancreas,  14 
peritoneum,  8 
pulse,  24 
single  colon,  14 
small  intestines,  11 
spleen,  14 

surgical  regions  of  the  abdo- 
men, 7 
temperature,  24 
weather    as    a    predisposing 
cause  of  colic,  33 
Time  occupied  in  passage  of  food 
through  digestive  canal  of 
horse,  31 
compared  with  man,  32 
Time  of  day,  influence  of,  on  pro- 
duction of  colic,  43 
Treatment  of  colic  in  foals,  221 

in  yearlings  and  two-year- 
olds,  219 
of  diarrhoea  in  young  animals, 

221 
of  enteritis,  209 
of  gastric  impaction,  50 

tympany,  65 
of    impaction  of    the    single 

colon,  143 

of  intestinal  tympany,  192 

of  paralysis  of  the  rectum,  143 

of  subacute  obstruction  of  the 

double  colon,  89 

small  intestines,  153 


INDEX 


261 


Treatment  of  subacute  obstruction 
of  the  pelvic  flexure  of  the 
double  colon,  134 
of  superpurgation,  216 
sedative,  of  intestinal  impac-' 

tion,  8g,  102 
stimulant,    of    intestinal    im- 
paction, 92,  143,  154 
Turpentine  inintestinal  impaction, 

100 
Tympanites,  i8g 
Tympany,  gastric,  52 
ammonia  in,  66 
antizymotics  in,  66 
case  of,  69 
causes  of,  54 
danger  of  sedatives  in,  68 
definition  of,  52 
diagnosis  of,  59 
eructation  in,  58 
gases  present  in,  65 
hydrate  of  iron  in  treatment 

of,  66 
prognosis  of,  64 
symptoms  of,  56 
treatment  of,  65 
vomition  in,  59,  65 
Tympany,  intestinal,  189 
causes  of,  189 


Tympany,  definition  of,  189 
diagnosis  of,  191 
enterocentesis  in,  192 
prognosis  of,  192 
puncturing  bowel  in,  192 
sedatives  in,  199 
symptoms  of,  igo 
treatment  of,  192 

Value  of  eserine  in  gastric  tym- 
pany, 69 

Various  exciting  causes  of  colic,  35 

Vomiting  as  diagnostic  of  ruptured 
stomach,  77 

Vomition,  hindrances  to,  20,  29 
in  gastric  tympany,  59,  65 

Water  as    an    exciting    cause  of 

colic,  37 
Water,  best  time  to,  39 
Watering,  methods  of,  39 
Weather,   the,  as  a  predisposing 

cause  of  colic,  33 

Yearlings  and  two-year-olds,  treat- 
ment of  colic  in,  219 
Young  animals,  intestinal  impac- 
tion in,  225 
treatment  of  diarrhoea  in,  222 


THE    END 


Bailliere.  Tindall  and  Cox,  8,  Henrietta  Street ^  Covent  Garden 


FEB  2  fi  2J05 


i 


S^    JUN82 


N.  MANCHESTER, 
INDIANA  4696? 


